Lipid Peroxidation and Options Antioxidant Therapy for Secondary Lymphedema of the Lower Extremities

NCT04360889 — Phase 4, Completed, 120 participants, Ryazan State Medical University

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RegistryNCT04360889
StatusCompleted
PhasePhase 4
Study typeInterventional; randomized, parallel, masking: none, treatment
Enrollment120 (Actual)
SponsorRyazan State Medical University (Other)
ConditionsLower Extremity Lymphedema
InterventionsMicronised purified flavonoid fraction (diosmin+flavonoids expressed as hesperidin), Tocopherol, Elastic compression (Drug, other)
Datesstart 2019-09-01, primary completion 2022-08-03, completion 2022-08-03, first posted 2020-04-24, last updated 2022-08-04
Locations1 site in Russia

Related Papers Related Patents Related Grants Related Experts
All trials for Lower Extremity Lymphedema All trials of Micronised purified flavonoid fraction (diosmin+flavonoids expressed as hesperidin) All trials of Tocopherol

-Summary

A single-center, open, prospective, randomized, controlled clinical trial will include 120 patients with lower limb lymphedema who undergo treatment in an office-based vascular lab at the Ryazan regional clinical cardiology dispensary, Ryazan, Russia. The patients will be recruited by the staff of the Department of cardiovascular, endovascular, operative surgery, and topographic anatomy, Ryazan state I.P. Pavlov medical university, Russia. The study will include patients who meet the inclusion criteria and do not meet the exclusion criteria. Patients will be divided into 4 groups, 30 subjects each. Group 1-patients with lower limb lymphedema who will receive conservative therapy with elastic compression and an antioxidant (Tocopherol-400 IU/day); Group 2-patients with lower limb lymphedema who will receive conservative therapy with Micronised purified flavonoid fraction (diosmin+flavonoids expressed as hesperidin)-1000mg/day) in addition to elastic compression; Group 3-patients with lower limb lymphedema who will be treated with elastic compression; Group 4- healthy volunteers with no history or clinical signs of venous or lymphatic disease; The duration of this study for each subject will be a maximum of 90 days. Pre-screening and screening will involve 200 subjects with a total of 120 subjects who will be randomized into the study. Peripheral blood samples will be collected to evaluate the activity of biochemical markers of endothelial function; the quality of life will also be assessed.

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+Detailed description

Research methods:

1. Physical examination;
2. peripheral blood sampling (assessment of the concentration of the markers of endothelial dysfunction, including malondialdehyde (MDA), superoxide dismutase (SD), catalase( CAT), glutathione peroxidase (GP). MDA concentration will be determined with a competitive enzyme immunoassay (ELISA), which will be performed using a General MDA assessment kit (manufacturer: USCN Life Science Inc. US-CEA597GE). CAT concentration will be determined using a competitive enzyme immunoassay (ELISA), which will be performed with a kit for quantitative in vitro assessment of catalase (manufacturer: USCN Life Science Inc. US-SEC418Hu). GP concentration will be determined with a competitive enzyme immunoassay (ELISA), which will be performed using a glutathione peroxidase quantification set (abfrontier supplier, Republic of Korea - LF- EK0110). SOD concentration will be determined using a competitive enzyme immunoassay (ELISA), which will be performed using a total superoxide dismutase detection kit (supplier Cayman Chemical Company, US - 706002).
3. Lower limb venous sonography with a linear 5-13 MHz probe;
4. Patient questionnaire using a Russian-language version of the Quality of life questionnaire "SF-36 Health Status Survey"

+Arms and interventions

ArmTypeInterventionsDescription
TocopherolExperimentalDrug: Tocopherolpatients with lower limb lymphedema who will receive conservative therapy with elastic compression and an antioxidant (Tocopherol-400 IU/day) - 90 days
Micronised purified flavonoid fractionExperimentalDrug: Micronised purified flavonoid fraction (diosmin+flavonoids expressed as hesperidin)patients with lower limb lymphedema who will receive conservative therapy with Micronised purified flavonoid fraction (diosmin+flavonoids expressed as hesperidin)-1000mg/day) in addition to elastic compression - 90 days
Elastic compressionOtherOther: Elastic compressionpatients with lower limb lymphedema who will be treated with elastic compression - 90 days
Healthy volunteersNo interventionhealthy volunteers with no history or clinical signs of venous or lymphatic disease - 90 days
  • Micronised purified flavonoid fraction (diosmin+flavonoids expressed as hesperidin) (Drug): Micronised purified flavonoid fraction (diosmin+flavonoids expressed as hesperidin) is prescribed at a dose of 1000 mg / day Tocopherol is prescribed at a dose of 400 ME/ day
  • Tocopherol (Drug): patients with lower limb lymphedema receiving conservative therapy (elastic compression, to which are added preparations with antioxidant endotheliotropic activity (Tocopherol-400 IU/day)
  • Elastic compression (Other): patients with lower limb lymphedema receiving conservative therapy that includes only the use of elastic compression

+Outcome measures

Primary outcomes

  • The malleolar volume of the limb [90 days]: The circumference at the level of the narrowest part of the lower leg, measured in centimeters
  • The Level Of Catalase [90 days]: Biochemical indicator of the functional state of the endothelium. Catalase concentration will be determined using a competitive enzyme immunoassay (ELISA), which will be performed with a kit for quantitative in vitro assessment of catalase (manufacturer: USCN Life Science Inc. US-SEC418Hu). Unit of measurement ng / ml
  • The Level Of Superoxide Dismutase [90 days]: Biochemical indicator of the functional state of the endothelium. Superoxide Dismutase concentration will be determined using a competitive enzyme immunoassay (ELISA), which will be performed using a total superoxide dismutase detection kit (supplier Cayman Chemical Company, US - 706002). Unit of measurement UI / ml
  • The Level Of Glutathione Peroxidase [90 days]: Biochemical indicator of the functional state of the endothelium. Glutathione Peroxidase concentration will be determined with a competitive enzyme immunoassay (ELISA), which will be performed using a glutathione peroxidase quantification set (abfrontier supplier, Republic of Korea - LF- EK0110). Unit of measurement ng / ml
  • The level of Malondialdehyde [90 days]: Biochemical indicator of the functional state of the endothelium. Malondialdehyde concentration will be determined with a competitive enzyme immunoassay (ELISA), which will be performed using a General MDA assessment kit (manufacturer: USCN Life Science Inc. US-CEA597GE). Unit of measurement ng / ml
  • Quality of life indicators: questionnaire [90 days]: Patient questionnaire using a Russian-language version of the Quality of life questionnaire "Short Form-36 Health Status Survey". 8 indicators. Indicator from 0 to 100. Higher scores mean a better outcome.

+Eligibility

Sex: All, accepts healthy volunteers

Inclusion Criteria:

* Secondary lymphedema of the lower extremities
* Signed Informed Consent Form

Exclusion Criteria:

* varicose veins of the lower extremities,
* deep vein thrombosis,
* post-thrombotic disease,
* obliterating
* atherosclerosis of the lower limb arteries,
* pregnancy,
* lactation,
* cancer,
* acute violation of cerebral circulation in the anamnesis,
* trophic lesions of the skin of the lower extremities,
* diabetes mellitus
* an infectious disease with a history of three months prior to inclusion in the study,
* heart failure,
* kidney failure,
* pulmonary insufficiency.

+Locations (1)

FacilityCityCountryStatus
Ryazan State Medical UniversityRyazanRussia