Treatment of chronic diabetic foot ulcers with bemiparin: a randomized, triple-blind, placebo-controlled, clinical trial.

Abstract

AIMS:

To assess the efficacy and safety of bemiparin in the treatment of chronic diabetic foot ulcers.

METHODS:

A triple-blind, parallel, randomized, placebo-controlled trial. Patients aged > 18 years, [corrected] with diabetes for at least 3 years, and with a foot ulcer persisting for > 3 months were selected from 39 Spanish centres. Bemiparin 3500 IU/day for 10 days, followed by 2500 IU/day for up to 3 months plus standard care for ulcers, was compared with placebo plus standard care for ulcers for 3 months. The primary efficacy end-point was ulcer improvement, defined as an objective decrease in ulcer area of >or= 50%, measured by digital photography and ImageJ software, and/or any decrease in Wagner's ulcer grade at 3 months.

RESULTS:

Ulcer improvement rates were 70.3% (26 of 37 patients) in the bemiparin group and 45.5% (15 of 33 patients) in the placebo group [absolute difference 24.8; 95% confidence interval (CI) 2.3, 47.3; P = 0.035] (number needed to treat 4; 95% CI 2, 43). Complete healing rates at 3 months were similar in both groups (35.1% vs. 33.3%; P = 0.874), as were the number of adverse events.

CONCLUSIONS:

Bemiparin is more effective than placebo in the management of diabetic foot ulcers and has few side-effects.

• Authors: M Rullan, L Cerdà, G Frontera, L Masmiquel, J Llobera
• Journal: Diabetic medicine : a journal of the British Diabetic Association (Diabet Med) Vol. 25 Issue 9 Pg. 1090-5 (Sep 2008) ISSN: 1464-5491 [Electronic] England
• PMID: 19183313 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Fibrinolytic Agents
• Heparin, Low-Molecular-Weight
• bemiparin

Topics

• Adult
• Aged
• Aged, 80 and over
• Diabetic Foot (drug therapy)
• Female
• Fibrinolytic Agents (therapeutic use)
• Heparin, Low-Molecular-Weight (therapeutic use)
• Humans
• Male
• Middle Aged
• Statistics as Topic
• Treatment Outcome
• Wound Healing (drug effects)