Sulodexide in angiological patients

Czech version

Authors: K. Roztočil
Authors‘ workplace: Klinika transplantační chirurgie, Institut klinické a experimentální medicíny, Praha
Published in: Kardiol Rev Int Med 2014, 16(4): 336-339
Category: Internal Medicine

Overview

Sulodexide is a compound belonging to the group of glycosaminoglycans (together with heparins). In comparison with other glycosaminoglycans, sulodexide has stronger antithrombotic properties and a lower risk of bleeding, and unlike heparin, it can be administered both parenterally and orally. Multiple pharmacodynamic effects of the preparation have been demonstrated. Clinical studies have documented the effectiveness of the drug in patients with claudication. There is evidence of its effect also in patients with the most severe cases of chronic venous insufficiency, including patients with active leg ulcers. In the case of a positive outcome of the ongoing studies, secondary prevention of venous thrombosis will be added as another indication.

Keywords:
sulodexid – glykosaminoglykany – claudication – leg ulcers – venous thrombosis

Sources

1. Nieuwdorp M, Mooij HL, Kroon J et al. Endothelial glycocalyx damage coincides with microalbuminuria in type 1 diabetes. Diabetes 2006; 55: 1127– 1132.

2. Broekhuizen LN, Lemkes BA, Mooij HL et al. Effect of sulodexide on endothelial glycocalyx and vascular permeability in patiens with type 2 diabetes mellitus. Diabetologia 2010; 53: 2646– 2655. doi: 10.1007/ s00125‑ 010‑ 1910‑ x.

3. Kristova V, Liskova S, Sotnikova R et al.: Sulodexide improves endothelial dysfunction in streptozotocin‑induced diabetes in rats. Physiol Res 2008; 57: 491– 494.

4. Crepaldi G, Fellin R, Calabro A et al. Double‑blind multicenter trial on a new nedium molecular glycosaminoglycan. Current therapeutic effects and perspectives for clinical use. Atherosclerosis 1990; 81: 233– 243.

5. Ciuffetti G, Mercuri M, Susta A et al. Effects of 3– glucosaminoglycan sulphate on hemorheologic parameters in hypolipidemic peripheral vascular disease (PVD) patients: a preliminary double‑blind cross‑ over study. Angiology 1989; 40: 255– 259.

6. Ceriello A, Quatraro M, Ettorre M et al. Glycosaminoglycans administration decreases fibrinogen in plasma levels in diabetic patients. Diab Nutr Metab 1993; 6: 1– 4.

7. Castellucio A., Bologna E. Effect of sulodexide on blood viscosity in patients with peripheral vascular disease. Curr Med Res Opin 1991; 12: 325– 331.

8. Lunetta M, Salanitri T. Lowering of plasma viscosity by the oral administration of the glycosaminoglycan sulodexide in patients with peripheral vascular disease. J Int Med Res 1992; 20: 45– 53.

9. Cospite M, Milio G, Ferrara F et al. Haemodynamic effects of sulodexide in post‑thrombophlebitic syndromes Acta Ther 1992; 18: 149– 161.

10. Coccheri S. Biological and clinical effects of sulodexide in arterial disorders and diseases. Int Angiol 2014; 33: 263– 274.

11. Hoppensteadt DA, Fareed J. Pharmacological profile of sulodexide. Int Angiol 2014; 33: 229– 235.

12. Gaddi A, Galetti C, Illumninati B et al. Meta‑analysis of some results of clinical trials on sulodexide therapy in peripheral occlusive arterial disease. J Int Med Res 1996; 24: 389– 406.

13. Coccheri S, Scondotto G, Agnelli G. Sulodexide in the tretment of intermittent claudication. Results of the randomized, double‑blůiond multicentre, placebo‑ controlled study. Eur Heart J 2002; 23: 1057– 1065.

14. Condorelli M, Chiariello M, Dagianti A et al. IPO‑ V2: a prospective, multicenter, randomized, comparative clinical investigation of the effects of sulodexide in preventing cardiovascular accidents in the first year after acute myocardial infarction. J Am Coll Cardiol 1994; 23: 27– 34.

15. Shustov SB. Controlled clinical trial on the efficacy and safety of oral sulodexide in patients with peripheral occlusive arterial disease. Curr Med Res Opin 1997; 13: 573– 582.

16. Norgren L, Hiatt WR, Dormandy JA et al. Inter‑ society consensus for the management of perpheral arterial disease (TASC II). Eur J Vasc Endovasc Surg 2007; 33: S5– S75.

17. Andreozzi GM. Sulodexide in the treatment of chronic venous disease. Am J Cardiovasc Drugs 2012; 12: 73– 81. doi: 10.2165/ 11599360‑ 000000000‑ 00000.

18. Coccheri S, Scondotto G, Agnelli G et al. Venous arm of the SUAVIS (Sulodexide Arterial Venous Italian Study) Group. Randomised, double‑blind, multicentre, placebo controlled study of sulodexide in the treatment of venous leg ulcers. Thromb Haemost 2002; 87: 947– 952.

19. Andreozzi GM. Role of sulodexide in the treatment of CVD. Int Angiol 2014; 33: 255– 262.

20. Kearon C, Kahn SR, Agnelli G et al. Antithrombotic therapy for venous thromboembolic disease. ACCP Guidelines (8th Edition). Chest 2008; 133: 454S‑ 545S. doi: 10.1378/ chest.08‑ 0658.

21. Errichi BM, Cesarone MR, Belcaro G et al. Prevention of recurrent deep venous thrombosis with sulodexide: the SanVal Registry. Angiology 2004, 55, 243– 249.