Clinical Efficacy of Micronized Purified Flavonoid Fraction: An Overview

Abstract

Flavonoids are widely used for the treatment of chronic venous insufficiency (CVI). In clinical trials, micronized purified flavonoid fraction (MPFF, 450 mg diosmin plus 50 mg hesperidin, Daflon 500 mg) has demonstrated its activity in CVI by improving venous tone and vein elasticity assessed by plethysmography. Randomized, double-blind, placebo-controlled clinical studies have shown an improvement in signs and symptoms related to CVI and a decrease in leg circumferences at the levels of the ankle and calf. The effect of MPFF on microcirculatory parameters suspected of participating in the pathophysiological process of venous ulceration has been investigated in patients. These include hemorheological parameters and transcutaneous oxygen tension measurements, which were shown to improve after treatment with MPFF. Finally, a randomized double-blind, placebo-controlled clinical study has shown that MPFF treatment for 2 months, in addition to standard compression therapy, accelerates leg ulcer healing in patients with ulcers ≤10 cm.

Venous Hypoxia: A Poorly Studied Etiological Factor of Varicose Veins

“…Despite the uncertainty, there are suggestions that tissue hypoxia may contribute to the remodelling seen in the varicose vein wall, and further investigation seems worthwhile. Furthermore, improving venous oxygenation, for example using flavonoids, may lead to symptomatic relief in CVI [17,19,66,67]. Interestingly, these drugs have been shown to improve venous oxygenation most likely by elevating venous tone, increasing ATP production, reducing vein wall inflammation and decreasing capillary permeability [35,64,66].…”

“…Furthermore, improving venous oxygenation, for example using flavonoids, may lead to symptomatic relief in CVI [17,19,66,67]. Interestingly, these drugs have been shown to improve venous oxygenation most likely by elevating venous tone, increasing ATP production, reducing vein wall inflammation and decreasing capillary permeability [35,64,66]. Moreover, improving our understanding of the role of hypoxia in varicose vein formation may lead to the discovery of further therapeutic targets for drug development in this disease.…”

“…It was also unclear whether the patients in the study received any other treatment such as compression which might have positive effects on the oxygenation of the luminal blood. Some randomized controlled trials have also reported that venoactive drugs such as flavonoids and horse-chestnut extracts improved symptoms of CVI [63,65,66,67]. These drugs are likely to increase venous tone and decrease vein wall inflammation and capillary permeability [6,63].…”

Effects of Micronised Purified Flavonoid Fraction on Pain, Spermiogram and Scrotal Color Doppler Parameters in Patients with Painful Varicocele

“…Micronised purifi ed fl avonoid fraction (MPFF), which consists of 90% micronised diosmin (a fl avone derivative) and 10% fl avonoids expressed as hesperidin (a fl avonone derivative), is an oral phlebotrophic drug which improves venous tone and elasticity and decreases venous distensibility and venous emptying times in patients with functional or organic chronic venous insuffi ciency (CVI) [6] . MPFF also improves lymphatic drainage in the advanced stage of CVI, reduces refl ux time of venous blood in patients with CVI and capillary hyperpermeability in patients suffering from idiopathic cyclic edema and symptomatic capillary fragility, and has antioxidant activities [6][7][8] .…”

“…MPFF also improves lymphatic drainage in the advanced stage of CVI, reduces refl ux time of venous blood in patients with CVI and capillary hyperpermeability in patients suffering from idiopathic cyclic edema and symptomatic capillary fragility, and has antioxidant activities [6][7][8] . It has an excellent safety profi le as documented by both toxicological animal studies and clinical studies, and has a tolerability profi le similar to that of placebo [6] . Most studies have shown that MPFF is an effective and well-tolerated drug in patients with chronic venous insuffi ciency.…”