Red vine leaf extract in managing venous disease: a practical narrative review and clinical recommendations

INTRODUCTION: Several molecules have been used in treating chronic venous disease (CVD) of lower limbs. Despite several studies on these compounds, guidelines recommendations are not so well defined, and the debate remains open on their real efficacy. The aim of this review is to assess and analyze both non-clinical and clinical data regarding the use of red vine leaf extract (RVLE), and to contextualize these findings within the pathophysiology of venous disorders.EVIDENCE ACQUISITION: A thorough examination of the available literature concerning the non-clinical pharmacology and clinical studies involving RVLE was conducted. The findings were carefully summarized and described, adopting recommendations for narrative review.EVIDENCE SYNTHESIS: RVLE is a well-standardized herbal product that accumulates in the venous intima, preserving endothelial function and inhibiting inflammatory/prothrombotic processes in CVD. Rigorous clinical trials with CVD patients demonstrated RVLE’s statistically significant and clinically relevant efficacy over placebo, improving objective and patient-reported outcomes. Additional studies validated these results in a broader population. RVLE is well-tolerated and can be used in combination with non-interventional and interventional therapies, complementing its hemodynamic effects at the cellular level and addressing a therapeutic gap, particularly for patients unable to use compression stockings.CONCLUSIONS: RVLE is a well-standardized, clinically validated, and safe treatment for chronic venous disease, improving outcomes and addressing an important therapeutic need.