Calcium Dobesilate

Chronic venous disease (CVD) is a prevalent condition that results from venous hypertension and leads to a variety of symptoms including leg pain, swelling, and venous ulcers. The condition significantly impacts quality of life (QoL) and imposes a burden on healthcare systems. Venoactive drugs (VADs) can manage CVD symptoms by improving venous tone, reducing inflammation, and enhancing microcirculation. In this review, six experts from Latin America provide a critical appraisal of the evidence supporting the use of VADs in CVD management. The review evaluates the efficacy of various VADs, including micronized purified flavonoid fraction (MPFF), rutosides, calcium dobesilate, sulodexide, horse chestnut seed extract, and red vine leaf extract. MPFF demonstrated robust efficacy in randomized controlled trials, significantly reducing symptoms such as pain, leg heaviness, and edema, and improving QoL. Other VADs, such as rutosides and calcium dobesilate, showed varying degrees of effectiveness, though the quality of supporting evidence remains inconsistent. This review also highlights variations in international guidelines - some recommending VADs more strongly than others, with MPFF emerging as the preferred option, supported by high-quality evidence. However, further research is necessary to clarify the role of other VADs and provide more definitive guidance on their use in clinical practice. PLAIN LANGUAGE SUMMARY: Chronic venous disease (CVD) is a condition that affects the veins in the legs, causing pain, swelling, and other symptoms like heaviness and cramping. It can also lead to more severe issues such as skin changes and ulcers. CVD is common and can greatly reduce a person's quality of life (QoL). It can also place a significant burden on healthcare systems. Venoactive drugs, or VADs, are medicines that help improve blood flow in the veins, reduce swelling, and ease inflammation. These drugs are used to alleviate CVD symptoms, especially when other conservative treatments, like compression stockings, are insufficient. This review describes the published evidence about different types of VADs and their effectiveness in CVD. Some drugs, like micronized purified flavonoid fraction (MPFF), have been shown to be particularly effective in reducing leg pain, swelling, and heaviness, as well as helping to improve the QoL of people with CVD. Other VADs, including rutosides, calcium dobesilate, and horse chestnut seed extract, have demonstrated clinical efficacy. Different medical guidelines for treating CVD from around the world recommend using VADs, though with some discrepancies on recommendation gradings. While MPFF is referred to in these guidelines as a leading option, further research is needed to better understand how different VADs can be used most effectively in treating CVD.