Micronized Purified Flavonoid Fraction in Hemorrhoid Disease: A Systematic Review and Meta-Analysis
Sheikh P, Lohsiriwat V, Shelygin Y
Published in Advances in Therapy
Methodology
Systematic review and meta-analysis of randomised clinical trials comparing micronized purified flavonoid fraction with placebo or no treatment for acute haemorrhoidal disease or symptom relief after medical or surgical management, with no limit on treatment duration; endpoints were bleeding, pain, pruritus, discharge or leakage and overall improvement.
Key Findings
From 351 records this systematic review included 11 studies (13 articles) comparing micronized purified flavonoid fraction with placebo or no treatment in haemorrhoidal disease. Quantitative meta-analysis of four studies found significant benefits for bleeding (odds ratio 0.082, 95% CI 0.027 to 0.250, p < 0.001), discharge or leakage (OR 0.12, 95% CI 0.04 to 0.42, p < 0.001) and overall improvement rated by patients (OR 5.25, 95% CI 2.58 to 10.68) and investigators (OR 5.51, 95% CI 2.76 to 11.0). Pain showed only a non-significant trend toward improvement (OR 0.11, 95% CI 0.01 to 1.11, p = 0.06).
Conclusions
MPFF improved the most important signs and symptoms of hemorrhoid disease.
Limitations
Only four of the 11 included studies could be pooled, the rest assessed qualitatively; effect sizes are implausibly large for a symptomatic treatment, and the authors have ties to the manufacturer of the branded product studied. An independent 2018 review of the same treatment reached far more cautious conclusions.
Related Health Concerns
Study Details
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