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Effectiveness and safety of a product containing diosmin, coumarin, and arbutin (Linfadren®) in addition to complex decongestive therapy on management of breast cancer-related lymphedema

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Abstract

Purpose

To assess the effectiveness and safety of a product containing diosmin, coumarin, and arbutin (Linfadren®) in addition to complex decongestive therapy (CDT) on the management of patients with a breast cancer-related lymphedema (BCRL).

Methods

Fifty outpatients (average age of 56.2 ± 2.7 years, range 28–71) with a BCRL were enrolled for this study. Patients were randomly assigned (1:1 ratio) to receive either CDT consisting of skin care, manual lymphatic drainage, remedial exercises, and elastic compression garment (control group, n = 25) or CDT plus Linfadren® (study group, n = 25). Patients were evaluated before and after treatment and 3 months after the end of treatment. Primary outcomes were reduction of upper limb excess volume (EV) and percentage reduction of excess volume (%REV). Secondary outcomes were improvement in Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, and patient’s perception of treatment effectiveness (PPTE).

Results

Addition of Linfadren® to CDT yielded an additional reduction of primary outcomes both after treatment (EV, − 521 ml vs. − 256 ml, P < 0.0001; %REV, − 66.4% vs. − 34%, P = 0.02) and at 3-month follow-up (EV, − 59 ml vs. + 24 ml, P < 0.0001; %REV, − 73.6% vs. − 31.4%, P = 0.004). Moreover, statistically significant differences were found between the two groups for the secondary outcomes after treatment (QuickDASH, P = 0.006; PPTE, P = 0.03) and at 3-month follow-up (QuickDASH, P = 0.006; PPTE, P = 0.02). No patient showed adverse events.

Conclusions

Linfadren® in addition to CDT was a safe and effective therapy for reducing BCRL and was better than CDT alone.

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Authors and Affiliations

  1. Department of Life, Health & Environmental Sciences, School of Medicine, University of L’Aquila, L’Aquila, Italy

    Angelo Cacchio & Giancarlo Di Carlo

  2. Università dell’Aquila, P.le San Salvatore 1 - Edificio Delta 6 Medicina, 67100, L’Aquila, Italy

    Angelo Cacchio

  3. Rehabilitation Service, “Serafino Rinaldi” Territorial Assistance Hospital of Pescina, ASL 01 Avezzano-Sulmona, L’Aquila, Pescina, Italy

    Angelo Cacchio, Marina Bertone, Luciana De Benedictis, Luciano Taglieri & Erika D’Elia

  4. Rehabilitation Service ex Polio Centre, ASL 01 Avezzano-Sulmona, L’Aquila, Avezzano, Italy

    Rosa Prencipe & Cesidia Centoletti

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  1. Angelo Cacchio
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Cacchio, A., Prencipe, R., Bertone, M. et al. Effectiveness and safety of a product containing diosmin, coumarin, and arbutin (Linfadren®) in addition to complex decongestive therapy on management of breast cancer-related lymphedema. Support Care Cancer 27, 1471–1480 (2019). https://doi.org/10.1007/s00520-018-4514-5

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