Premium
Recombinant human granulocyte‐macrophage colony‐stimulating factor applied locally in low doses enhances healing and prevents recurrence of chronic venous ulcers
Author(s) -
Jaschke Erna,
Zabernigg August,
Gattringer Claus
Publication year - 1999
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1046/j.1365-4362.1999.00665.x
Subject(s) - medicine , surgery , refractory (planetary science) , wound healing , quality of life (healthcare) , gastroenterology , physics , astrobiology , nursing
Background Chronic venous leg ulcers have a major medical and economic impact on the elderly worldwide. Healing of the large ulcers (>10 cm 2 ) occurs only in two‐thirds of the patients and reulceration of healed ulcers recurs in one‐third within 1 year. Because both healing and relapse rate influence greatly a patient’s quality of life and the overall cost of treatment, every effort should be made to improve these two parameters. Objective To determine the safety and efficacy of topical low‐dose recombinant human granulocyte‐macrophage colony‐stimulating factor (rhu GM‐CSF) for the treatment of venous ulcers, and to document any improvement in healing rates. Methods Thirty‐eight patients (29 women, 9 men; median age, 74 years) with chronic venous insufficiency were treated with topical rhu GM‐CSF (5 μg/mL 0.9% sodium chloride solution), followed by application of a compression dressing. All subjects were treated as outpatients. Results Complete healing was observed in 47 of the 52 ulcers (90.4%). The average healing time was 19 weeks. No systemic or local side‐effects from the therapy were observed. Nine chronic ulcers, previously refractory to conventional treatment (pretreatment for more than 46 weeks), showed the same response rate (9/8, or 88.9%) and healing time (mean, 19 weeks). After 40 months, no reulceration of the healed ulcers was observed, but two patients developed new ulcers on the same leg. Healing remained stable, with excellent cosmetic results. Conclusions In this first study, topically applied low‐dose rhu GM‐CSF was a safe treatment for chronic venous leg ulcers. Healing rates were significantly increased and relapse rates were minimal.