Effect of Micronized Purified Flavonoid Fraction on Vein-Specific Inflammatory Markers in Patients with Varicose Veins Disease

Objective. To evaluate the effect of micronized purified flavonoid fraction (MPFF) on vein-inflammatory markers (E-selectin, MCP-1, VEGF, MMP-2, MMP-9) and quality of life in patients with varicose veins, including combination with endovenous laser ablation (EVLA). Material and methods. A prospective study included 186 patients with varicose veins of clinical classes C2—C6 (CEAP), divided into four groups: group 1 used compression hosiery; group 2 received MPFF 1000 mg daily; group 3 underwent EVLA; group 4 received MPFF after EVLA. Biomarkers were measured before treatment, at 2 months, and at 12 months. Adverse events were recorded. Changes in quality of life were assessed using the CIVIQ-20 and SF-36 questionnaires. Results. At 2 months follow-up there was a significant reduction in E-selectin, MCP-1, and VEGF (p<0.001) in the MPFF group. Effect on MCP-1 and VEGF sustained up to 12 months in C2—C3 patients. MMP-2 and MMP-9 levels showed no significant change. After EVLA, there was a short-term decrease in E-selectin, MCP-1, and MMP-2. The most pronounced effects were observed in the EVLA+MPFF group: MCP-1 decreased by 46.2% at 2 months and 40.7% at 12 months; VEGF decreased by up to 52% (C2—C3) and 44.4% (C4—C6); E-selectin decreased by 36.2 and 29.9%, respectively. Quality of life improvement was greatest in the EVLA+MPFF group and persisted up to 12 months. No significant changes were registered in the compression group. Conclusions. MPFF exerts an anti-inflammatory effect, particularly in early-stage disease (C2—C3). The combination of EVLA and MPFF provides the most substantial and sustained reduction in inflammatory markers and the best quality-of-life outcomes. In advanced stages (C4—C6), prolonged pharmacotherapy is advisable.