Becaplermin gel in the treatment of diabetic neuropathic foot ulcers.
Diabetic foot ulcers remain a major cause of morbidity. Significant progress has been accomplished in ulcer healing by improved management of both ischemia and neuropathy in the diabetic foot. Nevertheless, there is a vital need for further improvement. Becaplermin gel represents an important therapeutic advance for diabetic neuropathic foot ulcers with adequate blood supply. Randomized controlled trials have shown that it is effective in increasing healing rates. However, this efficacy has not translated to positive clinical experience, and the drug is not widely used. Moreover, becaplermin is an expensive medication. Even though it has repeatedly been estimated as cost-effective, its high cost may be prohibitive for some clinicians, especially in developing countries. Clearly, further work is needed to clarify whether use of becaplermin is justified in everyday clinical practice. Future research also needs to assess the potential room for improvement with becaplermin, for instance by combination with other growth factors or by exploring alternative modes of drug delivery.
Papanas
Nikolaos
N
Outpatient Clinic of Obesity, Diabetes and Metabolism at the Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece. papanasnikos@yahoo.gr
Maltezos
Efstratios
E
D043925:Angiogenesis Inducing Agents / Q000627:therapeutic use*; D000077214:Becaplermin; D017719:Diabetic Foot / Q000188:drug therapy* / Q000503:physiopathology; D005782:Gels; D006801:Humans; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use*; D020574:Proto-Oncogene Proteins c-sis; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D043925:Angiogenesis Inducing Agents; D005782:Gels; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D000077214:Becaplermin