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Jill Waters - One of the best experts on this subject based on the ideXlab platform.
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Pentoxifylline for treating venous leg ulcers
Cochrane Database of Systematic Reviews, 2012Co-Authors: Andrew Jull, Bruce Arroll, Varsha Parag, Jill WatersAbstract:Background Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers remain unhealed, and some people are unsuitable for compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers but to date there has been no systematic review. Objectives To assess the effects of Pentoxifylline (oxpentifylline or Trental 400) for treating venous leg ulcers, compared with placebo, or other therapies, in the presence or absence of compression therapy. Search strategy We searched the Cochrane Peripheral Vascular Diseases and Wounds Groups specialised registers (date of last search was May 2001), and reference lists of relevant articles. We hand searched relevant journals and conference proceedings, and contacted Hoechst (the manufacturer of the drug) and experts in the field. Selection criteria Randomised trials comparing Pentoxifylline with placebo or other therapy in the presence or absence of compression, in patients with venous leg ulcers. Data collection and analysis Details from eligible trials were extracted and summarised by one reviewer using a coding sheet. Data extraction was independently verified by one other reviewer. Main results Nine trials involving 572 adults were included. The quality of trials was variable. Eight trials compared Pentoxifylline with placebo; in five of these trials patients received compression therapy. In one trial Pentoxifylline was compared with defibrotide in patients who also received compression. Combining eight trials that compared Pentoxifylline with placebo (with or without compression) demonstrated that Pentoxifylline is more effective than placebo in terms of complete ulcer healing or significant improvement (relative risk of healing with Pentoxifylline compared with placebo 1.41, 95% confidence interval 1.19 -1.66). Pentoxifylline plus compression is more effective than placebo plus compression (relative risk of healing with Pentoxifylline 1.30, 95% confidence interval 1.10-1.54). A comparison between Pentoxifylline and defibrotide found no statistically significant difference in healing rates. More adverse effects were reported in patients receiving Pentoxifylline, although this was not statistically significant (relative risk of adverse effects with Pentoxifylline 1.25, 95% confidence interval 0.87-1.80). Nearly half of the reported adverse effects were gastrointestinal. Authors' conclusions Pentoxifylline appears to be an effective adjunct to compression bandaging for treating venous ulcers. There was no cost effectiveness data available and healthcare commissioners may therefore conclude that it not be considered a routine adjunct. Pentoxifylline in the absence of compression may be effective for treating venous leg ulcers, although the evidence should be cautiously interpreted. The majority of adverse effects are gastrointestinal disturbances (indigestion, diarrhoea and nausea).
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The Cochrane Library - Pentoxifylline for treating venous leg ulcers
The Cochrane database of systematic reviews, 2007Co-Authors: Andrew Jull, Bruce Arroll, Varsha Parag, Jill WatersAbstract:Background Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers remain unhealed, and some people are unsuitable for compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers but to date there has been no systematic review. Objectives To assess the effects of Pentoxifylline (oxpentifylline or Trental 400) for treating venous leg ulcers, compared with placebo, or other therapies, in the presence or absence of compression therapy. Search strategy We searched the Cochrane Peripheral Vascular Diseases and Wounds Groups specialised registers (date of last search was May 2001), and reference lists of relevant articles. We hand searched relevant journals and conference proceedings, and contacted Hoechst (the manufacturer of the drug) and experts in the field. Selection criteria Randomised trials comparing Pentoxifylline with placebo or other therapy in the presence or absence of compression, in patients with venous leg ulcers. Data collection and analysis Details from eligible trials were extracted and summarised by one reviewer using a coding sheet. Data extraction was independently verified by one other reviewer. Main results Nine trials involving 572 adults were included. The quality of trials was variable. Eight trials compared Pentoxifylline with placebo; in five of these trials patients received compression therapy. In one trial Pentoxifylline was compared with defibrotide in patients who also received compression. Combining eight trials that compared Pentoxifylline with placebo (with or without compression) demonstrated that Pentoxifylline is more effective than placebo in terms of complete ulcer healing or significant improvement (relative risk of healing with Pentoxifylline compared with placebo 1.41, 95% confidence interval 1.19 -1.66). Pentoxifylline plus compression is more effective than placebo plus compression (relative risk of healing with Pentoxifylline 1.30, 95% confidence interval 1.10-1.54). A comparison between Pentoxifylline and defibrotide found no statistically significant difference in healing rates. More adverse effects were reported in patients receiving Pentoxifylline, although this was not statistically significant (relative risk of adverse effects with Pentoxifylline 1.25, 95% confidence interval 0.87-1.80). Nearly half of the reported adverse effects were gastrointestinal. Authors' conclusions Pentoxifylline appears to be an effective adjunct to compression bandaging for treating venous ulcers. There was no cost effectiveness data available and healthcare commissioners may therefore conclude that it not be considered a routine adjunct. Pentoxifylline in the absence of compression may be effective for treating venous leg ulcers, although the evidence should be cautiously interpreted. The majority of adverse effects are gastrointestinal disturbances (indigestion, diarrhoea and nausea).
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Oral Pentoxifylline for treatment of venous leg ulcers.
Journal of tissue viability, 2007Co-Authors: Andrew Jull, Jill Waters, Bruce ArrollAbstract:Background Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers do not respond to compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers but to date there has been no systematic review. Objectives To assess the effects of Pentoxifylline ('Trental 400') for treating venous leg ulcers, when compared with placebo, or in comparison with other therapies, in the presence or absence of compression therapy. Search strategy We searched the Cochrane Peripheral Vascular Diseases and Wounds Groups specialised registers (date of search August 1999), and reference lists of relevant articles. We hand searched relevant journals and conference proceedings, and contacted Hoechst (the manufacturer of the drug) and experts in the field. Selection criteria Randomised trials comparing Pentoxifylline with placebo or other therapy in the presence or absence of compression, in patients with venous leg ulcers. Data collection and analysis Details from eligible trials were extracted and summarised by one reviewer using a coding sheet. Data extraction was independently verified by one other reviewer. Main results Nine trials involving 572 adults were included. The quality of trials was variable. Eight trials compared Pentoxifylline with placebo; in five of these trials patients received compression therapy. In one trial Pentoxifylline was compared with defibrotide in patients who also received compression. By pooling eight trials that compared Pentoxifylline with placebo (with or without compression) it was found Pentoxifylline was more effective than placebo in terms of complete healing or significant improvement (relative risk for healing with Pentoxifylline compared with placebo 1.41, 95% confidence interval 1.19 -1.66). Pentoxifylline and compression was more effective than placebo and compression (relative risk for healing with Pentoxifylline 1.30, 95% confidence interval 1.10-1.54). Combination of similar trials using compression obtained a number needed to treat (NNT) of 7 (95%confidence interval 4-17). A comparison between Pentoxifylline and defibrotide found no difference in healing rates. More adverse effects were reported in the Pentoxifylline group, although this was not statistically significant (relative risk for adverse effects with Pentoxifylline 1. 25, 95% confidence interval 0.87-1.80). Nearly half of the adverse effects were reported to be gastro-intestinal. Reviewer's conclusions Pentoxifylline appears to be an effective adjunct to compression bandaging for treating venous ulcers. There was no cost effectiveness data available and healthcare commissioners may therefore conclude that it not be considered a routine adjunct. Pentoxifylline in the absence of compression may be effective for treating venous ulcers in the absence of compression, although the evidence should be cautiously interpreted. The majority of adverse effects are likely to be tolerated by patients, and gastrointestinal disturbances (indigestion, diarrhoea and nausea) are the most frequent adverse effect.
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Pentoxifylline for treatment of venous leg ulcers: a systematic review.
Lancet (London England), 2002Co-Authors: Andrew Jull, Jill Waters, Bruce ArrollAbstract:Summary Introduction Venous ulcers are usually treated with compression therapy, but, because this treatment may not be effective for some people, adjuvant therapy could be beneficial. We did a systematic review of randomised controlled trials that compared Pentoxifylline (with and without compression treatment) with placebo, or other treatments, in patients with venous leg ulcers. Methods We identified eight trials (547 adults), five of which compared Pentoxifylline and compression with placebo and compression (n=445), and three of which compared Pentoxifylline alone with placebo (102). Our main aim was to determine whether Pentoxifylline, with or without compression, was effective in treatment of venous leg ulcers. Analysis was by intention to treat. Findings Pentoxifylline was more effective than placebo in complete healing or substantial improvement of venous leg ulcers (relative risk 1·49, 95% CI 1·11-2·01). Pentoxifylline with compression was also more effective than placebo and compression in complete healing (1·30, 1·10-1·54). Patients taking Pentoxifylline had no more adverse events than those on placebo (1·25, 0·87-1·80). The most frequent adverse event was mild gastrointestinal disturbance (43%). Interpretation Our results suggest that Pentoxifylline gives additional benefit to compression for venous leg ulcers, and is possibly effective for patients not receiving compression.
Andrew Jull - One of the best experts on this subject based on the ideXlab platform.
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Pentoxifylline for treating venous leg ulcers
Cochrane Database of Systematic Reviews, 2012Co-Authors: Andrew Jull, Bruce Arroll, Varsha Parag, Jill WatersAbstract:Background Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers remain unhealed, and some people are unsuitable for compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers but to date there has been no systematic review. Objectives To assess the effects of Pentoxifylline (oxpentifylline or Trental 400) for treating venous leg ulcers, compared with placebo, or other therapies, in the presence or absence of compression therapy. Search strategy We searched the Cochrane Peripheral Vascular Diseases and Wounds Groups specialised registers (date of last search was May 2001), and reference lists of relevant articles. We hand searched relevant journals and conference proceedings, and contacted Hoechst (the manufacturer of the drug) and experts in the field. Selection criteria Randomised trials comparing Pentoxifylline with placebo or other therapy in the presence or absence of compression, in patients with venous leg ulcers. Data collection and analysis Details from eligible trials were extracted and summarised by one reviewer using a coding sheet. Data extraction was independently verified by one other reviewer. Main results Nine trials involving 572 adults were included. The quality of trials was variable. Eight trials compared Pentoxifylline with placebo; in five of these trials patients received compression therapy. In one trial Pentoxifylline was compared with defibrotide in patients who also received compression. Combining eight trials that compared Pentoxifylline with placebo (with or without compression) demonstrated that Pentoxifylline is more effective than placebo in terms of complete ulcer healing or significant improvement (relative risk of healing with Pentoxifylline compared with placebo 1.41, 95% confidence interval 1.19 -1.66). Pentoxifylline plus compression is more effective than placebo plus compression (relative risk of healing with Pentoxifylline 1.30, 95% confidence interval 1.10-1.54). A comparison between Pentoxifylline and defibrotide found no statistically significant difference in healing rates. More adverse effects were reported in patients receiving Pentoxifylline, although this was not statistically significant (relative risk of adverse effects with Pentoxifylline 1.25, 95% confidence interval 0.87-1.80). Nearly half of the reported adverse effects were gastrointestinal. Authors' conclusions Pentoxifylline appears to be an effective adjunct to compression bandaging for treating venous ulcers. There was no cost effectiveness data available and healthcare commissioners may therefore conclude that it not be considered a routine adjunct. Pentoxifylline in the absence of compression may be effective for treating venous leg ulcers, although the evidence should be cautiously interpreted. The majority of adverse effects are gastrointestinal disturbances (indigestion, diarrhoea and nausea).
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The Cochrane Library - Pentoxifylline for treating venous leg ulcers
The Cochrane database of systematic reviews, 2007Co-Authors: Andrew Jull, Bruce Arroll, Varsha Parag, Jill WatersAbstract:Background Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers remain unhealed, and some people are unsuitable for compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers but to date there has been no systematic review. Objectives To assess the effects of Pentoxifylline (oxpentifylline or Trental 400) for treating venous leg ulcers, compared with placebo, or other therapies, in the presence or absence of compression therapy. Search strategy We searched the Cochrane Peripheral Vascular Diseases and Wounds Groups specialised registers (date of last search was May 2001), and reference lists of relevant articles. We hand searched relevant journals and conference proceedings, and contacted Hoechst (the manufacturer of the drug) and experts in the field. Selection criteria Randomised trials comparing Pentoxifylline with placebo or other therapy in the presence or absence of compression, in patients with venous leg ulcers. Data collection and analysis Details from eligible trials were extracted and summarised by one reviewer using a coding sheet. Data extraction was independently verified by one other reviewer. Main results Nine trials involving 572 adults were included. The quality of trials was variable. Eight trials compared Pentoxifylline with placebo; in five of these trials patients received compression therapy. In one trial Pentoxifylline was compared with defibrotide in patients who also received compression. Combining eight trials that compared Pentoxifylline with placebo (with or without compression) demonstrated that Pentoxifylline is more effective than placebo in terms of complete ulcer healing or significant improvement (relative risk of healing with Pentoxifylline compared with placebo 1.41, 95% confidence interval 1.19 -1.66). Pentoxifylline plus compression is more effective than placebo plus compression (relative risk of healing with Pentoxifylline 1.30, 95% confidence interval 1.10-1.54). A comparison between Pentoxifylline and defibrotide found no statistically significant difference in healing rates. More adverse effects were reported in patients receiving Pentoxifylline, although this was not statistically significant (relative risk of adverse effects with Pentoxifylline 1.25, 95% confidence interval 0.87-1.80). Nearly half of the reported adverse effects were gastrointestinal. Authors' conclusions Pentoxifylline appears to be an effective adjunct to compression bandaging for treating venous ulcers. There was no cost effectiveness data available and healthcare commissioners may therefore conclude that it not be considered a routine adjunct. Pentoxifylline in the absence of compression may be effective for treating venous leg ulcers, although the evidence should be cautiously interpreted. The majority of adverse effects are gastrointestinal disturbances (indigestion, diarrhoea and nausea).
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Oral Pentoxifylline for treatment of venous leg ulcers.
Journal of tissue viability, 2007Co-Authors: Andrew Jull, Jill Waters, Bruce ArrollAbstract:Background Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers do not respond to compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers but to date there has been no systematic review. Objectives To assess the effects of Pentoxifylline ('Trental 400') for treating venous leg ulcers, when compared with placebo, or in comparison with other therapies, in the presence or absence of compression therapy. Search strategy We searched the Cochrane Peripheral Vascular Diseases and Wounds Groups specialised registers (date of search August 1999), and reference lists of relevant articles. We hand searched relevant journals and conference proceedings, and contacted Hoechst (the manufacturer of the drug) and experts in the field. Selection criteria Randomised trials comparing Pentoxifylline with placebo or other therapy in the presence or absence of compression, in patients with venous leg ulcers. Data collection and analysis Details from eligible trials were extracted and summarised by one reviewer using a coding sheet. Data extraction was independently verified by one other reviewer. Main results Nine trials involving 572 adults were included. The quality of trials was variable. Eight trials compared Pentoxifylline with placebo; in five of these trials patients received compression therapy. In one trial Pentoxifylline was compared with defibrotide in patients who also received compression. By pooling eight trials that compared Pentoxifylline with placebo (with or without compression) it was found Pentoxifylline was more effective than placebo in terms of complete healing or significant improvement (relative risk for healing with Pentoxifylline compared with placebo 1.41, 95% confidence interval 1.19 -1.66). Pentoxifylline and compression was more effective than placebo and compression (relative risk for healing with Pentoxifylline 1.30, 95% confidence interval 1.10-1.54). Combination of similar trials using compression obtained a number needed to treat (NNT) of 7 (95%confidence interval 4-17). A comparison between Pentoxifylline and defibrotide found no difference in healing rates. More adverse effects were reported in the Pentoxifylline group, although this was not statistically significant (relative risk for adverse effects with Pentoxifylline 1. 25, 95% confidence interval 0.87-1.80). Nearly half of the adverse effects were reported to be gastro-intestinal. Reviewer's conclusions Pentoxifylline appears to be an effective adjunct to compression bandaging for treating venous ulcers. There was no cost effectiveness data available and healthcare commissioners may therefore conclude that it not be considered a routine adjunct. Pentoxifylline in the absence of compression may be effective for treating venous ulcers in the absence of compression, although the evidence should be cautiously interpreted. The majority of adverse effects are likely to be tolerated by patients, and gastrointestinal disturbances (indigestion, diarrhoea and nausea) are the most frequent adverse effect.
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Pentoxifylline for treatment of venous leg ulcers: a systematic review.
Lancet (London England), 2002Co-Authors: Andrew Jull, Jill Waters, Bruce ArrollAbstract:Summary Introduction Venous ulcers are usually treated with compression therapy, but, because this treatment may not be effective for some people, adjuvant therapy could be beneficial. We did a systematic review of randomised controlled trials that compared Pentoxifylline (with and without compression treatment) with placebo, or other treatments, in patients with venous leg ulcers. Methods We identified eight trials (547 adults), five of which compared Pentoxifylline and compression with placebo and compression (n=445), and three of which compared Pentoxifylline alone with placebo (102). Our main aim was to determine whether Pentoxifylline, with or without compression, was effective in treatment of venous leg ulcers. Analysis was by intention to treat. Findings Pentoxifylline was more effective than placebo in complete healing or substantial improvement of venous leg ulcers (relative risk 1·49, 95% CI 1·11-2·01). Pentoxifylline with compression was also more effective than placebo and compression in complete healing (1·30, 1·10-1·54). Patients taking Pentoxifylline had no more adverse events than those on placebo (1·25, 0·87-1·80). The most frequent adverse event was mild gastrointestinal disturbance (43%). Interpretation Our results suggest that Pentoxifylline gives additional benefit to compression for venous leg ulcers, and is possibly effective for patients not receiving compression.
Bruce Arroll - One of the best experts on this subject based on the ideXlab platform.
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Pentoxifylline for treating venous leg ulcers
Cochrane Database of Systematic Reviews, 2012Co-Authors: Andrew Jull, Bruce Arroll, Varsha Parag, Jill WatersAbstract:Background Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers remain unhealed, and some people are unsuitable for compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers but to date there has been no systematic review. Objectives To assess the effects of Pentoxifylline (oxpentifylline or Trental 400) for treating venous leg ulcers, compared with placebo, or other therapies, in the presence or absence of compression therapy. Search strategy We searched the Cochrane Peripheral Vascular Diseases and Wounds Groups specialised registers (date of last search was May 2001), and reference lists of relevant articles. We hand searched relevant journals and conference proceedings, and contacted Hoechst (the manufacturer of the drug) and experts in the field. Selection criteria Randomised trials comparing Pentoxifylline with placebo or other therapy in the presence or absence of compression, in patients with venous leg ulcers. Data collection and analysis Details from eligible trials were extracted and summarised by one reviewer using a coding sheet. Data extraction was independently verified by one other reviewer. Main results Nine trials involving 572 adults were included. The quality of trials was variable. Eight trials compared Pentoxifylline with placebo; in five of these trials patients received compression therapy. In one trial Pentoxifylline was compared with defibrotide in patients who also received compression. Combining eight trials that compared Pentoxifylline with placebo (with or without compression) demonstrated that Pentoxifylline is more effective than placebo in terms of complete ulcer healing or significant improvement (relative risk of healing with Pentoxifylline compared with placebo 1.41, 95% confidence interval 1.19 -1.66). Pentoxifylline plus compression is more effective than placebo plus compression (relative risk of healing with Pentoxifylline 1.30, 95% confidence interval 1.10-1.54). A comparison between Pentoxifylline and defibrotide found no statistically significant difference in healing rates. More adverse effects were reported in patients receiving Pentoxifylline, although this was not statistically significant (relative risk of adverse effects with Pentoxifylline 1.25, 95% confidence interval 0.87-1.80). Nearly half of the reported adverse effects were gastrointestinal. Authors' conclusions Pentoxifylline appears to be an effective adjunct to compression bandaging for treating venous ulcers. There was no cost effectiveness data available and healthcare commissioners may therefore conclude that it not be considered a routine adjunct. Pentoxifylline in the absence of compression may be effective for treating venous leg ulcers, although the evidence should be cautiously interpreted. The majority of adverse effects are gastrointestinal disturbances (indigestion, diarrhoea and nausea).
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The Cochrane Library - Pentoxifylline for treating venous leg ulcers
The Cochrane database of systematic reviews, 2007Co-Authors: Andrew Jull, Bruce Arroll, Varsha Parag, Jill WatersAbstract:Background Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers remain unhealed, and some people are unsuitable for compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers but to date there has been no systematic review. Objectives To assess the effects of Pentoxifylline (oxpentifylline or Trental 400) for treating venous leg ulcers, compared with placebo, or other therapies, in the presence or absence of compression therapy. Search strategy We searched the Cochrane Peripheral Vascular Diseases and Wounds Groups specialised registers (date of last search was May 2001), and reference lists of relevant articles. We hand searched relevant journals and conference proceedings, and contacted Hoechst (the manufacturer of the drug) and experts in the field. Selection criteria Randomised trials comparing Pentoxifylline with placebo or other therapy in the presence or absence of compression, in patients with venous leg ulcers. Data collection and analysis Details from eligible trials were extracted and summarised by one reviewer using a coding sheet. Data extraction was independently verified by one other reviewer. Main results Nine trials involving 572 adults were included. The quality of trials was variable. Eight trials compared Pentoxifylline with placebo; in five of these trials patients received compression therapy. In one trial Pentoxifylline was compared with defibrotide in patients who also received compression. Combining eight trials that compared Pentoxifylline with placebo (with or without compression) demonstrated that Pentoxifylline is more effective than placebo in terms of complete ulcer healing or significant improvement (relative risk of healing with Pentoxifylline compared with placebo 1.41, 95% confidence interval 1.19 -1.66). Pentoxifylline plus compression is more effective than placebo plus compression (relative risk of healing with Pentoxifylline 1.30, 95% confidence interval 1.10-1.54). A comparison between Pentoxifylline and defibrotide found no statistically significant difference in healing rates. More adverse effects were reported in patients receiving Pentoxifylline, although this was not statistically significant (relative risk of adverse effects with Pentoxifylline 1.25, 95% confidence interval 0.87-1.80). Nearly half of the reported adverse effects were gastrointestinal. Authors' conclusions Pentoxifylline appears to be an effective adjunct to compression bandaging for treating venous ulcers. There was no cost effectiveness data available and healthcare commissioners may therefore conclude that it not be considered a routine adjunct. Pentoxifylline in the absence of compression may be effective for treating venous leg ulcers, although the evidence should be cautiously interpreted. The majority of adverse effects are gastrointestinal disturbances (indigestion, diarrhoea and nausea).
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Oral Pentoxifylline for treatment of venous leg ulcers.
Journal of tissue viability, 2007Co-Authors: Andrew Jull, Jill Waters, Bruce ArrollAbstract:Background Healing of venous leg ulcers is improved by the use of compression bandaging but some venous ulcers do not respond to compression therapy. Pentoxifylline, a drug which helps blood flow, has been used to treat venous leg ulcers but to date there has been no systematic review. Objectives To assess the effects of Pentoxifylline ('Trental 400') for treating venous leg ulcers, when compared with placebo, or in comparison with other therapies, in the presence or absence of compression therapy. Search strategy We searched the Cochrane Peripheral Vascular Diseases and Wounds Groups specialised registers (date of search August 1999), and reference lists of relevant articles. We hand searched relevant journals and conference proceedings, and contacted Hoechst (the manufacturer of the drug) and experts in the field. Selection criteria Randomised trials comparing Pentoxifylline with placebo or other therapy in the presence or absence of compression, in patients with venous leg ulcers. Data collection and analysis Details from eligible trials were extracted and summarised by one reviewer using a coding sheet. Data extraction was independently verified by one other reviewer. Main results Nine trials involving 572 adults were included. The quality of trials was variable. Eight trials compared Pentoxifylline with placebo; in five of these trials patients received compression therapy. In one trial Pentoxifylline was compared with defibrotide in patients who also received compression. By pooling eight trials that compared Pentoxifylline with placebo (with or without compression) it was found Pentoxifylline was more effective than placebo in terms of complete healing or significant improvement (relative risk for healing with Pentoxifylline compared with placebo 1.41, 95% confidence interval 1.19 -1.66). Pentoxifylline and compression was more effective than placebo and compression (relative risk for healing with Pentoxifylline 1.30, 95% confidence interval 1.10-1.54). Combination of similar trials using compression obtained a number needed to treat (NNT) of 7 (95%confidence interval 4-17). A comparison between Pentoxifylline and defibrotide found no difference in healing rates. More adverse effects were reported in the Pentoxifylline group, although this was not statistically significant (relative risk for adverse effects with Pentoxifylline 1. 25, 95% confidence interval 0.87-1.80). Nearly half of the adverse effects were reported to be gastro-intestinal. Reviewer's conclusions Pentoxifylline appears to be an effective adjunct to compression bandaging for treating venous ulcers. There was no cost effectiveness data available and healthcare commissioners may therefore conclude that it not be considered a routine adjunct. Pentoxifylline in the absence of compression may be effective for treating venous ulcers in the absence of compression, although the evidence should be cautiously interpreted. The majority of adverse effects are likely to be tolerated by patients, and gastrointestinal disturbances (indigestion, diarrhoea and nausea) are the most frequent adverse effect.
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Pentoxifylline for treatment of venous leg ulcers: a systematic review.
Lancet (London England), 2002Co-Authors: Andrew Jull, Jill Waters, Bruce ArrollAbstract:Summary Introduction Venous ulcers are usually treated with compression therapy, but, because this treatment may not be effective for some people, adjuvant therapy could be beneficial. We did a systematic review of randomised controlled trials that compared Pentoxifylline (with and without compression treatment) with placebo, or other treatments, in patients with venous leg ulcers. Methods We identified eight trials (547 adults), five of which compared Pentoxifylline and compression with placebo and compression (n=445), and three of which compared Pentoxifylline alone with placebo (102). Our main aim was to determine whether Pentoxifylline, with or without compression, was effective in treatment of venous leg ulcers. Analysis was by intention to treat. Findings Pentoxifylline was more effective than placebo in complete healing or substantial improvement of venous leg ulcers (relative risk 1·49, 95% CI 1·11-2·01). Pentoxifylline with compression was also more effective than placebo and compression in complete healing (1·30, 1·10-1·54). Patients taking Pentoxifylline had no more adverse events than those on placebo (1·25, 0·87-1·80). The most frequent adverse event was mild gastrointestinal disturbance (43%). Interpretation Our results suggest that Pentoxifylline gives additional benefit to compression for venous leg ulcers, and is possibly effective for patients not receiving compression.
Tun-jun Tsai - One of the best experts on this subject based on the ideXlab platform.
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renoprotective effect of combining Pentoxifylline with angiotensin converting enzyme inhibitor or angiotensin ii receptor blocker in advanced chronic kidney disease
Journal of the Formosan Medical Association, 2014Co-Authors: Pingmin Chen, Yung-ming Chen, Taishuan Lai, Pingyu Chen, Chunfu Lai, Wenchih Chiang, Tun-jun TsaiAbstract:Background/Purpose Several studies have shown the renoprotective effects of Pentoxifylline in the treatment of chronic kidney disease (CKD). This study was conducted to examine whether there was an increased benefit of including Pentoxifylline with angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) in the treatment of CKD. Methods A single-center retrospective analysis was conducted. A total of 661 Stage 3B-5 CKD patients who received ACEI or ARB treatment were recruited. The patients were divided into the Pentoxifylline use group and the no Pentoxifylline group. Renal survival analysis of the two groups was compared. Subgroup analysis was performed by dividing the patients into lower [urine protein to creatinine ratio (UPCR) Results There was no between-groups difference regarding mortality and cardiovascular events. Addition of Pentoxifylline showed a better renal outcome (p = 0.03). The protective effect of add-on Pentoxifylline was demonstrated in the higher proteinuria subgroup (p = 0.005). In the multivariate Cox regression model, Pentoxifylline use also showed a better renal outcome [hazard ratio (HR): 0.705; 95% confidence interval (CI): 0.498–0.997; p = 0.048]. This effect was more prominent in the higher proteinuria subgroup (HR: 0.602; 95% CI: 0.413–0.877; p = 0.008). Conclusion In the advanced stages of CKD, patients treated with a combination of Pentoxifylline and ACEI or ARB had a better renal outcome than those treated with ACEI or ARB alone. This effect was more prominent in the higher proteinuria subgroup. More large randomized control trials are needed to provide concrete evidence of the add-on effect of Pentoxifylline.
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Vasodilator Agents Modulate Rat Glomerular Mesangial Cell Growth and Collagen Synthesis
Nephron, 1995Co-Authors: Tun-jun Tsai, Yung-ming Chen, Feng-nien Ko, Chih Cheng Chang, Chau-fong Chen, Che-ming TengAbstract:Mesangial cell activation and extracellular matrix accumulation are hallmarks of many forms of glomerulonephropathy. We investigated the effect of several agents possessing vasodilating activities on rat mesangial cell growth and collagen synthesis. Using cell counting and a modified MTT assay, it was shown that dipyridamole, Pentoxifylline, dicentrine, prazosin and doxazosin all caused a dose-dependent inhibition of serum-stimulated rat mesangial cell proliferation. Platelet-derived growth factor-induced cell proliferation was also inhibited by doxazosin and Pentoxifylline. Dipyridamole and Pentoxifylline inhibited collagen synthesis in confluent mesangial cells while dicentrine and doxazosin did not. The procollagen alpha 1 (I) mRNA expression was also decreased by dipyridamole and Pentoxifylline. These results suggested that, in addition to dipyridamole, Pentoxifylline and alpha 1-adrenoceptor blockers may have a potential to delay the progression of chronic glomerulopathy associated with mesangial proliferation.
Diarmaid D Houlihan - One of the best experts on this subject based on the ideXlab platform.
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systematic review Pentoxifylline for the treatment of severe alcoholic hepatitis
Alimentary Pharmacology & Therapeutics, 2013Co-Authors: Richard D Parker, Matthew J Armstrong, Christopher Corbett, Ian A Rowe, Diarmaid D HoulihanAbstract:Summary Background Acute alcoholic hepatitis (AH) is a severe manifestation of alcoholic liver disease with a grave prognosis. Pentoxifylline, an oral antitumour necrosis factor agent, has been reported to reduce mortality and incidence of hepatorenal syndrome (HRS) in severe alcoholic hepatitis (SAH). Aim To summarise evidence for the use of Pentoxifylline in SAH. Methods A literature search was undertaken using MeSH terms ‘hepatitis, alcoholic’ and ‘Pentoxifylline’ using the set operator AND. We included randomised controlled trials examining Pentoxifylline in SAH, published as abstracts or full manuscripts. Risk ratios (RRs) were calculated for pooled data using random effects modelling. Risk of bias was assessed using Cochrane group criteria and quality of trials assessed using ‘Consolidated Standards of Reporting Trials’ CONSORT guidelines. Results Ten trials including 884 participants were included, from six papers and four abstracts. There was significant heterogeneity between trials regarding control groups and trial end-points. Treatment was given for 28 days in all trials except one. Pooling of data showed a reduced incidence of fatal HRS with Pentoxifylline compared with placebo (RR: 0.47, 0.26–0.86, P = 0.01), but no survival benefit at 1 month (RR: 0.58, 0.31–1.07, P = 0.06). There were no significant differences between treatment groups in trials of Pentoxifylline vs. corticosteroid, or vs. combination therapy. Conclusions Pentoxifylline appears superior to placebo in prevention of fatal HRS and thus may be effective treatment of SAH when corticosteroids are contraindicated. However, multiple trials have failed to show conclusive superiority of either Pentoxifylline or corticosteroids.