Effectiveness and safety of a mixture of diosmin, coumarin and arbutin (Linfadren®) in addition to conventional treatment in the management of patients with post-trauma/surgery persistent hand edema: a randomized controlled trial

Abstract

Objective: To evaluate the effectiveness and safety of oral administration of Linfadren^® in addition to conventional treatment in patients with post-trauma/surgery persistent hand edema.

Design: Parallel-group randomized controlled trial.

Setting: Outpatient rehabilitation center.

Subjects: A total of 60 outpatients (mean age 48.5 (standard deviation (SD) = 12.3) years) with post-trauma/surgery persistent hand edema.

Interventions: Patients were randomized to either receive six-week conventional treatment plus Linfadren^® (Study Group) or conventional treatment (Control Group).

Main measures: Primary outcome was hand edema as measured by figure-of-eight method. Secondary outcomes were hand function, patient's overall perceived treatment effectiveness and rescue medication request. Tolerability of Linfadren^® was also evaluated. Assessments were performed at baseline, at the end of treatment and three months after the end of treatment.

Results: All patients completed the six-week program and 57 patients (95%) completed the three-month follow-up. At six weeks, the Study Group had significantly greater improvement in hand edema (423.3 (SD = 23.8) mm vs 439.4 (SD = 22.6) mm; P = 0.009) and upper limb function ( Quick Disabilities of Arm, Shoulder and Hand questionnaire: 23.6 (SD = 13.6) vs 37.7 (SD = 15.9); P = 0.005) compared to the Control Group. Moreover, the percentage of patients who perceived treatment as effective was significantly higher in the Study Group than in the Control Group both after treatment (70% vs 37%, P = 0.002) and at follow-up (77% vs 30%, P < 0.0001). The rescue medication request was not different between groups. No adverse events were recorded.

Conclusion: Linfadren^® in addition to conventional treatment was safe and more effective than conventional treatment alone in patients with post-trauma/surgery persistent hand edema.

Keywords: Edema; benzopyrones; coumarin; diosmin; forearm; hand; rehabilitation; surgery; trauma.