EFFECTIVENESS OF MICRONIZED PURIFIED FLAVONOID FRACTION AS ADJUNCTIVE THERAPY IN PATIENTS WITH VARICOSE VEINS: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Varicose veins are a common manifestation of chronic venous disease (CVD) and are associated with symptoms such as pain, edema, heaviness, and impaired quality of life (QoL). Micronized purified flavonoid fraction (MPFF), a venoactive agent composed primarily of diosmin and hesperidin, has been widely used for symptomatic management of CVD because of its venotonic, anti-inflammatory, and microcirculatory effects. Objective: To evaluate the prescribing patterns, clinical outcomes, and safety of MPFF in patients with varicose veins receiving pharmacological management and/or surgical intervention. Methods: A prospective longitudinal observational study was conducted among 120 patients with varicose veins (CEAP classes C2–C6) attending the Department of Vascular Surgery at Sheth H.J. Mahagujarat Hospital, Nadiad, India. Patients were managed either conservatively or surgically according to clinical indications and were further categorized based on MPFF use. Clinical outcomes were assessed using the Venous Clinical Severity Score (VCSS), Visual Analogue Scale (VAS) for pain, ulcer healing status, and quality of life (QoL) at baseline and during follow-up visits over a 3-month period. Safety outcomes were documented throughout the study. Results: The study included 120 patients with a mean age of 50.6 ± 19.6 years, of whom 50% were male. Thirteen patients received conservative treatment (MPFF, n=10; non-MPFF, n=3), while 107 underwent surgical intervention (MPFF, n=82; non-MPFF, n=25). Patients receiving MPFF demonstrated greater improvements in VCSS and VAS pain scores during follow-up compared with those not receiving MPFF. Complete ulcer healing was observed in surgical patients treated with MPFF, whereas limited improvement was noted in the non-MPFF group. Quality-of-life scores showed clinically meaningful improvement among MPFF-treated patients. Reported adverse events during follow-up included itching, dizziness, and weakness; however, causality with MPFF treatment could not be definitively established. Conclusion: MPFF administered at a daily dose of 1000 mg for three months was associated with improved clinical outcomes, including reduced symptom severity, enhanced ulcer healing, and better quality of life in patients with varicose veins. These findings support the use of MPFF as an adjunctive venoactive therapy in the management of chronic venous disease. Nevertheless, larger controlled studies with longer follow-up are warranted to confirm these observations.