Onset, Time Course and Duration of Venoactive Drugs Effect on Venous Symptoms in Patients with Chronic Venous Disease

Onset and duration of effect of venoactive drug (VAD) and topical agent on venous symptoms are unclear. Objective — to determine onset and duration of the effect of treatment with VAD and/or local gel use on venous symptoms. Material and methods. 121 patients (C1—C3S) were included in the multicenter prospective study. First group patients received VAD with topical agent. Second group patients received VAD only. Third group patients received local agent only. Duration of therapy was 2 months. Leg’s discomfort related to venous symptoms, quality of life, effect onset, duration of the effect after therapy completion were assessed. The symptoms were registered at 10 visits: beginning of therapy, after one, two, four, six and weeks (end of therapy), 3, 4, 5 and 6 months after the start of therapy. Results. 88, 82 and 76% of patients reported complete symptoms resolution or significant improving in the first, second and third groups, respectively. The effect was increasing during the first month of therapy with 70—80% of patients with improvement by this time. Baseline discomfort level was a predictor of insufficient effect. The higher level was related to worse results (OR=0.97 (95% CI: 0.94—0.99), p=0.017). Gender, age, CEAP disease class, obesity did not affect the result. The use of a local agent alone was associated with a higher probability of symptom persistence (OR=2.89 (95% CI: 0.97—8.54), p=0.056). Symptoms increased and returned within 4 months after discontinuation of therapy. Complete return of symptoms occurred in 22, 16 and 38% of patients in the first, second and third groups, respectively by the end of the follow-up. Conclusions. A two-month course of VAD treatment (and/or local gel use) effectively alleviates venous symptoms. Next course should be prescribed between one and four months after completing the two-month course, depending on increasing of symptoms severity. The use of a local agent alone is less effective, the achieved result is less stable.