Benefits of micronized purified flavonoid fraction as adjuvant therapy on inflammatory response after sclerotherapy

BACKGROUND: Sclerotherapy is the treatment of choice for telangiectasias. The aim of this study was to investigate the systemic and local inflammatory response after sclerotherapy in women with chronic venous disease (CVD) and to assess the effects of micronized purified flavonoid fraction (MPFF) in combination with sclerotherapy on markers of inflammation and endothelial dysfunction. METHODS: Sixty women with primary CVD CEAP class C-1 were randomly assigned sclerotherapy in combination with MPFF treatment (N=30) or sclerotherapy alone (control) group (N.=30). In the treatment group, patients received MPFF tablets 1000 mg daily for 2 weeks before the scheduled sclerotherapy and for at least 2 months after the procedure. Microsclerotherapy was performed according to standard protocol using modern sclerosing agents. Blood samples were collected from the central vein of the target vascular cluster before and 10 days after sclerotherapy to evaluate markers of inflammation and endothelial dysfunction including: C-reactive protein within the high-sensitivity range, histamine, interleukin-1, tumor necrosis factor-alpha, and vascular endothelial growth factor. To measure the systemic inflammatory response, blood samples were also collected from the forearm vein in 15 control patients. RESULTS: Baseline levels of markers of inflammation and endothelial dysfunction obtained from the central vein of the treatment site showed no statistically significant differences between treatment groups. In both groups, all markers were significantly increased 10 days after sclerotherapy. In the control group, the same markers obtained from the forearm were not modified 10 days after sclerotherapy indicating the inflammatory reaction was local and not systemic. MPFF treatment reduced all markers of inflammation and endothelial dysfunction compared with the control group. CONCLUSIONS: Prescription of MPFF starting prior to sclerotherapy and throughout the post-operative period reduced the vein-specific pro-inflammatory reaction and may thereby reduce the unwanted side effects of sclerotherapy and improve treatment outcomes.