IMPACT OF PHARMACOLOGICAL TREATMENT OF CHRONIC VENOUS DISEASE ON PATIENTS' QUALITY OF LIFE AND SOCIAL FUNCTIONING
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6035Keywords:
Chronic Venous Disease, Quality of Life, Social Functioning, Health-related Quality of Life, CIVIQ, PhlebotonicsAbstract
Aim: The aim of this study was to review the literature on the efficacy of phlebotonics in the treatment of chronic venous disease (CVD) of the lower limbs, with particular emphasis on their impact on patients' quality of life, social functioning and daily activity.
Materials and Methods: A narrative literature review was conducted in PubMed/MEDLINE, Cochrane Library, Google Scholar and ScienceDirect, covering publications from 1992 to 2026. A total of 22 references were included – randomised controlled trials, systematic reviews, meta-analyses and review articles.
Results: Chronic venous disease significantly impairs patients' quality of life in both physical and psychosocial dimensions. Phlebotonics act primarily symptomatically, reducing pain, oedema and limb heaviness, which translates into improved daily functioning and social activity. Micronized purified flavonoid fraction (MPFF) has the best-documented efficacy in symptom reduction and quality of life improvement, assessed with the CIVIQ-20 questionnaire, with the highest level of evidence according to GRADE. Results of available studies are inconclusive and depend on the type of phlebotonic used and measurement tools applied.
Conclusions: Phlebotonics should not be treated as a homogeneous therapeutic class, as individual substances differ in efficacy profile and mechanism of action. Effective pharmacological management of CVD contributes to improved social functioning and health-related quality of life. Further clinical studies with longer observation periods and standardised quality of life tools are needed to better understand the full impact of these drugs on patients' everyday lives.
References
Arcangeli, P. (2000). Pycnogenol in chronic venous insufficiency. Fitoterapia, 71(3), 236–244. https://doi.org/10.1016/s0367-326x(99)00164-1
Belczak, S. Q., Sincos, I. R., Campos, W., Beserra, J., Nering, G., & Aun, R. (2014). Veno-active drugs for chronic venous disease: A randomized, double-blind, placebo-controlled parallel-design trial. Phlebology, 29(7), 454–460. https://doi.org/10.1177/0268355513489550
Cesarone, M. R., Belcaro, G., Rohdewald, P., Pellegrini, L., Ledda, A., Vinciguerra, G., Ricci, A., Gizzi, G., Ippolito, E., Fano, F., Dugall, M., Acerbi, G., Cacchio, M., Di Renzo, A., Hosoi, M., Stuard, S., & Corsi, M. (2006). Comparison of Pycnogenol and Daflon in treating chronic venous insufficiency: A prospective, controlled study. Clinical and Applied Thrombosis/Hemostasis, 12(2), 205–212. https://doi.org/10.1177/107602960601200209
Danielsson, G., Jungbeck, C., Peterson, K., & Norgren, L. (2002). A randomised controlled trial of micronised purified flavonoid fraction vs placebo in patients with chronic venous disease. European Journal of Vascular and Endovascular Surgery, 23(1), 73–76. https://doi.org/10.1053/ejvs.2001.1531
Eklöf, B., Rutherford, R. B., Bergan, J. J., Carpentier, P. H., Gloviczki, P., Kistner, R. L., Meissner, M. H., Moneta, G. L., Myers, K., Padberg, F. T., Perrin, M., Ruckley, C. V., Smith, P. C., & Wakefield, T. W. (2004). Revision of the CEAP classification for chronic venous disorders: Consensus statement. Journal of Vascular Surgery, 40(6), 1248–1252. https://doi.org/10.1016/j.jvs.2004.09.027
Felice, F., Belardinelli, E., Frullini, A., Santoni, T., Imbalzano, E., & Di Stefano, R. (2018). Effect of aminaphtone on in vitro vascular permeability and capillary-like maintenance. Phlebology, 33(9), 592–599. https://doi.org/10.1177/0268355517737662
Gadzińska, P., Czechowicz, M., & Madoń, J. (2026). Therapy effectiveness of venous leg ulcer treatment methods: A comparative review. Journal of Education, Health and Sport. https://doi.org/10.12775/JEHS.2026.87.67960
Gloviczki, M. L., Kakkos, S. K., Urbanek, T., Chuback, J., & Nicolaides, A. (2025). The role of venoactive compounds in the treatment of chronic venous disease. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 13(5), 102258. https://doi.org/10.1016/j.jvsv.2025.102258
Gulati, O. P. (2014). Pycnogenol® in chronic venous insufficiency and related venous disorders. Phytotherapy Research, 28(3), 348–362. https://doi.org/10.1002/ptr.5019
Kakkos, S. K., & Nicolaides, A. N. (2018). Efficacy of micronized purified flavonoid fraction (Daflon®) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: A systematic review and meta-analysis of randomized double-blind placebo-controlled trials. International Angiology, 37(2), 143–154. https://doi.org/10.23736/S0392-9590.18.03975-5
Launois, R., Reboul-Marty, J., & Henry, B. (1996). Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Quality of Life Research, 5(6), 539–554. https://doi.org/10.1007/BF00439228
Liu, J., Li, S., & Sun, D. (2019). Calcium dobesilate and micro-vascular diseases. Life Sciences, 221, 348–353. https://doi.org/10.1016/j.lfs.2019.02.023
Maggioli, A., & Carpentier, P. (2019). Efficacy of MPFF 1000 mg oral suspension on CVD C0s-C1-related symptoms and quality of life. International Angiology, 38(2), 83–89. https://doi.org/10.23736/S0392-9590.18.04054-3
Mansilha, A., & Sousa, J. (2018). Pathophysiological mechanisms of chronic venous disease and implications for venoactive drug therapy. International Journal of Molecular Sciences, 19(6), 1669. https://doi.org/10.3390/ijms19061669
Martínez-Zapata, M. J., Moreno, R. M., Gich, I., Urrútia, G., & Bonfill, X. (2008). A randomized, double-blind multicentre clinical trial comparing the efficacy of calcium dobesilate with placebo in the treatment of chronic venous disease. European Journal of Vascular and Endovascular Surgery, 35(3), 358–365. https://doi.org/10.1016/j.ejvs.2007.08.012
Martinez-Zapata, M. J., Vernooij, R. W. M., Simancas-Racines, D., Uriona Tuma, S. M., Stein, A. T., Moreno Carriles, R. M. M., Vargas, E., & Bonfill Cosp, X. (2020). Phlebotonics for venous insufficiency. Cochrane Database of Systematic Reviews, 2020(11), CD003229. https://doi.org/10.1002/14651858.CD003229.pub4
Pittler, M. H., & Ernst, E. (2012). Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database of Systematic Reviews, 2012(11), CD003230. https://doi.org/10.1002/14651858.CD003230.pub4
Porter, J. M., & Moneta, G. L. (1995). Reporting standards in venous disease: An update. Journal of Vascular Surgery, 21(4), 635–645. https://doi.org/10.1016/s0741-5214(95)70195-8
Rabe, E., Guex, J. J., Puskas, A., Scuderi, A., & Fernandez Quesada, F. (2012). Epidemiology of chronic venous disorders in geographically diverse populations: Results from the Vein Consult Program. International Angiology, 31(2), 105–115.
Salwa, A., Gajdzińska, N., Rostkowska, W., Rutkowski, W., Rzepka, M., Sztuba, K., Puchała, J., Rymaszewska, K., Starzomska, D., & Basiura, K. (2024). Can physical exercise improve venous function in the context of chronic venous diseases? The impact of sport on varicose veins of the lower limbs: A review. Quality in Sport, 17, 53793. https://doi.org/10.12775/QS.2024.17.53793
Serra, R., Ielapi, N., Bitonti, A., Candido, S., Fregola, S., Gallo, A., Loria, A., Muraca, L., Raimondo, L., Velcean, L., Guadagna, S., & Gallelli, L. (2021). Efficacy of a low-dose diosmin therapy on improving symptoms and quality of life in patients with chronic venous disease. Nutrients, 13(3), 999. https://doi.org/10.3390/nu13030999
Wadworth, A. N., & Faulds, D. (1992). Hydroxyethylrutosides: A review of its pharmacology, and therapeutic efficacy in venous insufficiency and related disorders. Drugs, 44(6), 1013–1032. https://doi.org/10.2165/00003495-199244060-00009
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Copyright (c) 2026 Emilia Dedio, Wiktoria Michalska, Karolina Gaweł, Gabriela Augustynowicz, Klaudia Dziuba, Leon Miller, Weronika Matera, Aleksandra Kozik, Aleksandra Majewska, Wiktoria Podlasiewicz

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