Veno-active drugs in the management of chronic venous disease. An international consensus statement: current medical position, prospective views and final resolution.
BACKGROUND
Veno-active drugs (VAD) have effects on edema and symptoms related to chronic venous disease (CVD), especially so-called venous pain. VAD's effectiveness, although well established, is regularly debated.


OBJECTIVE
Our purpose was to select all randomized controlled trials (RCTs) and meta-analyses devoted to VAD and symptoms in CVD, to submit them to a group of international experts in CVD and to vote with secrete ballot to determine the level of efficacy of each drug, according to EBM (Evidence-Based Medicine) rules and critical analysis.


METHODS
Publications in any language devoted to VAD and venous symptoms were searched for in different databanks and submitted to the experts prior to the meeting.


RESULTS
83 papers were analyzed, including 72 RCTs or meta-analyses. Experts determined the level of EBM of each drug, according to the literature and personal experience, using 3 levels of recommendation, A, B and C (from large RCTs to non-randomized trials).


CONCLUSIONS
VAD are effective and may be applied in CVD when symptomatic, from C0s to C6s. However, etiological treatment of venous reflux and venous hypertension has always priority. In some cases VAD may replace compression and/or complement its effects. If respecting these prerequisites, VAD are safe and effective.
Ramelet
A A
AA
Angiologie & Dermatologie, Lausanne, Switzerland. aaramelet@hin.ch
Boisseau
M R
MR
Allegra
C
C
Nicolaides
A
A
Jaeger
K
K
Carpentier
P
P
Cappelli
R
R
Forconi
S
S
D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D014652:Vascular Diseases / Q000188:drug therapy*; D014662:Vasoconstrictor Agents / Q000145:classification / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000145:classification / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents