Micronized Purified Flavonoid Fraction in Hemorrhoid Disease: A Systematic Review and Meta-Analysis.

Content Provider	Europe PMC
Author	Sheikh, Parvez Lohsiriwat, Varut Shelygin, Yury
Abstract	IntroductionHemorrhoidal disease (HD) is a common and recurrent problem for many adults worldwide. Venoactive drugs, such as micronized purified flavonoid fraction (MPFF; Daflon®), have been used to treat HD and their clinical benefits have been demonstrated in previous meta-analyses of clinical trials. The aim of this study was to evaluate the efficacy of MPFF across the broader spectrum of signs and symptoms following treatment of patients with HD.MethodsWe performed a systematic review of the literature to identify randomized clinical trials in which MPFF treatment was compared to placebo or no treatment for acute HD or for relief of symptoms after patients had undergone medical management or a surgical procedure to remove hemorrhoids. The main endpoints investigated were bleeding, pain, pruritus, discharge or leakage, and overall improvement. There was no limit on treatment duration.ResultsFrom 351 unique records retrieved, 11 studies reported in 13 articles were included. On the basis of findings from qualitative analysis, MPFF was reported in most studies to be beneficial in treating bleeding, pain, pruritus, anal discharge/leakage, and tenesmus, and in overall improvement. Quantitative meta-analysis of four studies indicated that MPFF treatment provided significant benefits for bleeding (odds ratio [OR] 0.082, 95% confidence interval [CI] 0.027–0.250; P < 0.001), discharge/leakage (OR 0.12, 95% CI 0.04–0.42; P < 0.001), and overall improvement according to patients (OR 5.25, 95% CI 2.58–10.68; P < 0.001) and investigators (OR 5.51, 95% CI 2.76–11.0; P < 0.001). MPFF also tended to decrease pain (OR 0.11, 95% CI 0.01–1.11; P = 0.06).ConclusionTaken together, these results suggest that MPFF treatment can improve the most important signs and symptoms of HD.
ISSN	0741238X
Journal	Advances in Therapy
Volume Number	37
PubMed Central reference number	PMC7467450
Issue Number	6
PubMed reference number	32399811
e-ISSN	18658652
DOI	10.1007/s12325-020-01353-7
Language	English
Publisher	Springer Healthcare
Publisher Date	2020-05-12
Publisher Place	Cheshire
Access Restriction	Open
Rights License	Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. © The Author(s) 2020
Subject Keyword	Hemorrhoidal disease Hemorrhoidectomy Hemorrhoids Micronized purified flavonoid fraction MPFF Venoactive drugs
Content Type	Text
Resource Type	Article
Subject	Pharmacology (medical)