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Chronic venous disease (CVD) is highly prevalent and has a significant impact on patients and the health care system [1, 2]. Patients may experience a range of signs and symptoms, including leg discomfort, heaviness, fatigue, itching, cramps, paraesthesia, restless legs, oedema and varicose veins, as well as skin changes ranging from telangiectasias to venous ulceration [2]. It is, therefore, not surprising that CVD has a negative impact on patient quality of life (QoL) that correlates with disease severity [3].
Physicians need to understand the impact of CVD on their patients in order to manage it effectively, including which manifestation of CVD has the greatest impact on the patient. To assist with this, Servier sponsored a symposium at the 22nd annual meeting of the European Venous Forum in Venice, Italy (June 30th, 2022), entitled “Symptom relief for better quality of life in CVD: Patients’ and physicians’ perspectives”. The symposium began with videos of two CVD patients talking about their condition. For both patients, symptoms began when they were in their 20s or 30s. One (a 50-year-old woman with CVD for more than 20 years) described symptoms of tingling and discomfort (a sense of having very swollen legs) that began about 2 h after getting up and persisted throughout the day. As a result, she felt very tired at the end of the day and had to rest her legs until the sensations subsided. This prevented her from doing anything else but resting at the end of each day. In addition, she disliked the cosmetic appearance of her legs, which were marked with bluish/purplish veins. The other patient (a 35-year-old woman with CVD for the last 2–3 years) described heaviness, like having weights attached to her legs, and cramps that could occur at any time of the day and night. Her CVD caused her intense physical and mental fatigue, and emotionally she experienced feelings of unfairness and sadness. These patients described what they needed from their physicians as: (1) information about the evolution of the disease and what they could expect in the future, (2) thorough assessment and measurement of their symptoms, and (3) understanding and ‘a listening ear’ particularly in relation to the impact of CVD on their daily lives.
This supplement summarises the three presentations in the symposium, which addressed a number of the issues faced in CVD management. Dr Fabricio Santiago described recent research showing that the perspectives of the impact of CVD in patients and physicians often differ [4]. Drs Lurie and Branisteanu described how treatment with micronised purified flavonoid fraction (MPFF) works on the underlying pathophysiology of CVD, and how this translates into clinical effects, including those on QoL [5]. Dr Jorge Ulloa reviewed real-world evidence and how it complements the findings of randomised clinical trials to inform treatment decisions in CVD [6]. With CVD management, it is useful to keep in mind the famous quote by William Osler (1849–1919): “The good physician treats the disease; the great physician treats the patient who has the disease” [7].
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Branisteanu DE, Feodor T, Baila S, Mitea IA, Vittos O. Impact of chronic venous disease on quality of life: results of vein alarm study. Exp Ther Med. 2019;17(2):1091–6. https://doi.org/10.3892/etm.2018.7054.
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Lurie F, Branisteanu DE. Improving Chronic Venous Disease Management with Micronised Purified Flavonoid Fraction: New Evidence from Clinical Trials to Real Life. Clin Drug Investig. 2023. https://doi.org/10.1007/s40261-023-01261-y.
Ulloa JH. Optimising Decision Making in Chronic Venous Disease Management with Micronised Purified Flavonoid Fraction. Clin Drug Investig. 2023. https://doi.org/10.1007/s40261-023-01263-w.
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Acknowledgements
We would like to thank Catherine Rees who wrote the first draft on behalf of Springer Healthcare Communications. This medical writing assistance was funded by Servier.
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Maleti, O. Foreword. Clin Drug Investig 43 (Suppl 1), 1–2 (2023). https://doi.org/10.1007/s40261-023-01262-x
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DOI: https://doi.org/10.1007/s40261-023-01262-x