Preview

Koloproktologia

Advanced search

The effectiveness of combined topical product with fluocortolone pivalate and lidocaine for hemorrhoids: results of a multicenter observational study

https://doi.org/10.33878/2073-7556-2021-20-4-70-86

Abstract

AIM: to assess the changes in hemorrhoids symptoms and satisfaction with treatment against the background of treatment with a combined topical product Relief® Pro.

PATIENTS AND METHODS: multicenter prospective non-interventional cohort study was done in 13 clinical centers in Russia. The study included patients aged 18 to 65 years with acute hemorrhoids of stages 1–2 treated with the combined product Relief® Pro (rectal suppositories, cream or a combination thereof). The follow-up period was up to 14 days (in the case of 2 visits to the clinical center after receiving the initial data). The analysis was performed on the basis of data obtained at Visit 2 (5–7 days of therapy) and Visit 3 (10–14 days of therapy) vs the initial data (Visit 1). Following criteria were used: the severity of hemorrhoid symptoms on the Sodergren scale, the severity of hemorrhoid symptoms (pain, bleeding, itching, edema, the presence of discharge, a feeling of discomfort), the size of the largest hemorrhoid node, the satisfaction of the doctor and the patient with treatment, assessment of the patient’s adherence to recommendations for lifestyle changes and treatment, evaluation of the use of the drug Relief® were evaluated as endpoints About the treatment process and patient preferences regarding the dosage form of the prescribed drug. In addition, adverse events were evaluated.

RESULTS: the study included 1000 patients aged 18 to 65 years (men — 54.5%, women — 45.5%) Patients had grade 1 acute hemorrhoids (330 patients), grade 2 acute hemorrhoids (345 patients) and exacerbation of chronic hemorrhoids (325 patients). The drug Relief® Pro rectal cream was used by 333 patients; suppositories — 383 patients; joint therapy with both dosage forms — 284 patients. During follow-up (visits 2 and 3), positive dynamics was observed in patients — a decrease in the severity of hemorrhoid symptoms both during objective examination and according to patient questionnaires. So, according to the patients’ estimates, the use of Relief® Pro, regardless of the form, led to a decrease in the severity or disappearance of the main symptoms of hemorrhoids — bleeding, itching, edema, the presence of discharge, discomfort already by Visit 2 and in almost all patients by the end of observation. A similar change of the symptoms due the digital examination: by day 5–7, the severity of edema and bleeding in the perianal region, bleeding decreased. About 96% of patients and about 97% of doctors were satisfied with the treatment. Application of both forms of Relief® The ABM was characterized by good tolerability: there were no adverse events associated, according to the researcher, with the studied drug.

CONCLUSIONS: combined topical product Relief® Pro is effective for hemorrhoids.

About the Authors

I. V. Kostarev
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation

Kostarev Ivan V

Salyama Adilya str., 2, Moscow, 123423



M. A. Agapov
Medical Scientific and Educational Center of Lomonosov Moscow State University

Agapov Mikhail A. 

Lomonosovsky Ave., 27 building 10, Moscow, 119234



V. S. Groshilin
Federal State Budgetary Educational Institution Rostov State Medical University of the Ministry of Health of the Russian Federation

Groshilin Vitaly S.

Nakhichevan per., 29, Rostov-on-Don, 344022



L. G. Dvaladze
Federal State Budgetary Research Center named after L.G. Sokolov of the Federal Medico-biological agency of Russia

Dvaladze Liya G.

Kultury Ave., 4, St. Petersburg, 194291



D. A. Tvorogov
Federal State Budgetary Research Center named after L.G. Sokolov of the Federal Medico-biological agency of Russia

Tvorogov Dmitry A.

Kultury Ave., 4, St. Petersburg, 194291



M. Z. Churgulia
Federal State Budgetary Research Center named after L.G. Sokolov of the Federal Medico-biological agency of Russia

Churgulia Mamuka Z.

Kultury Ave., 4, St. Petersburg, 194291



References

1. Shelygin Yu.A., Blagodarny L.A. Reference of coloproctologist. Moscow: Literra. 2012; с.64 - 89. (in Russ.).

2. Vorobiev G.I., Shelygin Yu.A., Blagodarny L.A. Haemorrhoids. M .: Littera. 2010; pp. 38-40, 114-116, 137-138, 154-183. (in Russ.).

3. Corman ML. Hemorrhoids. In: Corman ML, eds. Colon and rectal surgery. 6th ed. Philadelphia, USA: Lippincott; 2013; pp.272-366.

4. Wald A, Bharucha AE, Cosman BC, Whitehead WE. ACG clinical guideline: management of benign anorectal disorders. Am J Gastroenterol. 2014; 109:1141 - 1157, (Quiz) 1058.

5. Bradley RD, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum. 2018; 61:284-292.

6. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: an epidemiologic study. Gastroenterology. 1990; 98: 380-386.

7. Wienert V., Llitz H., Raulf F. Handbuch Ha¨morrhoidalleiden. Uni-Med Brennen. 2008; 30.

8. Kaidar-Person O, Person B, Wexner SD. Hemorrhoidal disease: a comprehensive review. J Am Coll Surg. 2007; 204: 102–117.

9. Acheson AG, Scholefield JH. Management of haemorrhoids. BMJ. 2008;336: 380–383

10. Martinez-Zapata MJ, Vernooij RW, Uriona Tuma SM, Stein AT, et al. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev. 2016 Apr 6;4(4):CD003229. DOI: 10.1002/14651858.CD003229.pub3. Update in: Cochrane Database Syst Rev. 2020 Nov 3;11:CD003229. PMID: 27048768; PMCID: PMC7173720.

11. Pauwels R. Mode of action of corticosteroids in asthma and rhinitis. Clin Allergy. 1986; 16: 281-288.

12. Truss M, Beato M. Steroid hormone receptors: interaction with deoxyribonucleic acid and transcription factors. Endocr Rev. 1993; 14: 459–479

13. Schimmer BP, Parker KL. Adrenocorticotropic hormone; Adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones. In: Hardman J.G., Limbird L.E., Goodman Gilman A (Hrsg.), Goodman and Gilman’s The Pharmacological Basis of Therapeutics (10. Aufl.). New York, McGraw-Hill. 2001; p.1649–1678.

14. Corman ML. Colon and rectal surgery. 5th ed. Philadelfia: Lippincott; 2004.

15. Neiger A H.E. The symptomatic therapy of hemorrhoids and anal eczema - a report of experiences from proctology practice. Schweiz Rundsch Med Prax. 1990; 79: 918–920

16. Abramowitz L, Weyandt G, Havlickova B. The diagnosis and management of haemorrhoidal disease from a global perspective. Aliment Pharmacol Ther. 2010; 31(1):1-58.

17. Ivanov V.V., Lebedev I.S., Blagodarny L.A. Role of local therapy of pain syndrome in patients after hemorroidectomy. Koloproktologia. 2019;19(4):110–115. (in Russ.). DOI: 10.33878/2073-7556-2019-18-4-110-115

18. Shelygin Yu.A., Frolov S.A., Titov A.Yu., Blagodarny L.A., et al. Clinical recommendations of the Association of Coloproctology of Russia on the diagnosis and treatment of hemorrhoids. Koloproktologia. 2019;18(1):7–38. (in Russ.). DOI: 10.33878/2073-7556-2019-18-1-7-38


Review

For citations:


Kostarev I.V., Agapov M.A., Groshilin V.S., Dvaladze L.G., Tvorogov D.A., Churgulia M.Z. The effectiveness of combined topical product with fluocortolone pivalate and lidocaine for hemorrhoids: results of a multicenter observational study. Koloproktologia. 2021;20(4):70-86. https://doi.org/10.33878/2073-7556-2021-20-4-70-86

Views: 3295


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2073-7556 (Print)
ISSN 2686-7303 (Online)