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

Phase 4
Completed
Conditions
Lower Extremity Lymphedema
Interventions
Drug: Micronised purified flavonoid fraction (diosmin+flavonoids expressed as hesperidin)
Other: Elastic compression
Registration Number
NCT04360889
Lead Sponsor
Ryazan State Medical University
Brief 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.

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"

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
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.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Micronised purified flavonoid fractionMicronised 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 compressionElastic compressionpatients with lower limb lymphedema who will be treated with elastic compression - 90 days
TocopherolTocopherolpatients with lower limb lymphedema who will receive conservative therapy with elastic compression and an antioxidant (Tocopherol-400 IU/day) - 90 days
Primary Outcome Measures
NameTimeMethod
The level of Malondialdehyde90 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

The malleolar volume of the limb90 days

The circumference at the level of the narrowest part of the lower leg, measured in centimeters

The Level Of Catalase90 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 Dismutase90 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 Peroxidase90 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

Quality of life indicators: questionnaire90 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.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Ryazan State Medical University

🇷🇺

Ryazan', Russian Federation

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