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Advancing pharmacotherapy for diabetic foot ulcers.
Expert Opin Pharmacother 2019; 20(9):1153-1160EO

Abstract

INTRODUCTION

Standard treatment for diabetic foot ulcers (DFUs) includes off-loading, debridement, moisture balance, management of infection and peripheral arterial disease (PAD) as well as adequate glycemic control. The outcomes so far are unsatisfactory.

AREAS COVERED

Herein, the authors provide an outline of newer pharmacological agents for the management of DFUs and give their expert perspectives on future treatment strategies.

EXPERT OPINION

Evidence-based healthcare calls for high quality evidence from large RCTs before the implementation of new guidelines for the management of DFUs. Empagliflozin and liraglutide can be recommended for glucose control in patients with DFUs and PAD, while intensive lipid lowering therapy with evolocumab when primary cholesterol goals are not met could be offered to patients with DFUs. Further clinical studies are warranted to develop a structured algorithm for the treatment of DFUs that fail to heal after four weeks of current standard of care. Sucrose octasulfate dressings, becaplermin gel, and platelet-rich plasma (PRP) could also be considered as advanced treatment options for the management of hard to heal DFUs.

Authors+Show Affiliations

a Diabetes Centre, First Department of Propaedeutic Internal Medicine , Medical School, National and Kapodistrian University of Athens, Laiko General Hospital , Athens , Greece.a Diabetes Centre, First Department of Propaedeutic Internal Medicine , Medical School, National and Kapodistrian University of Athens, Laiko General Hospital , Athens , Greece.a Diabetes Centre, First Department of Propaedeutic Internal Medicine , Medical School, National and Kapodistrian University of Athens, Laiko General Hospital , Athens , Greece.b Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine , Democritus University of Thrace , Alexandroupolis , Greece.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

30958725

Citation

Eleftheriadou, Ioanna, et al. "Advancing Pharmacotherapy for Diabetic Foot Ulcers." Expert Opinion On Pharmacotherapy, vol. 20, no. 9, 2019, pp. 1153-1160.
Eleftheriadou I, Tentolouris A, Tentolouris N, et al. Advancing pharmacotherapy for diabetic foot ulcers. Expert Opin Pharmacother. 2019;20(9):1153-1160.
Eleftheriadou, I., Tentolouris, A., Tentolouris, N., & Papanas, N. (2019). Advancing pharmacotherapy for diabetic foot ulcers. Expert Opinion On Pharmacotherapy, 20(9), pp. 1153-1160. doi:10.1080/14656566.2019.1598378.
Eleftheriadou I, et al. Advancing Pharmacotherapy for Diabetic Foot Ulcers. Expert Opin Pharmacother. 2019;20(9):1153-1160. PubMed PMID: 30958725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advancing pharmacotherapy for diabetic foot ulcers. AU - Eleftheriadou,Ioanna, AU - Tentolouris,Anastasios, AU - Tentolouris,Nikolaos, AU - Papanas,Nikolaos, Y1 - 2019/04/08/ PY - 2019/4/9/pubmed PY - 2019/4/9/medline PY - 2019/4/9/entrez KW - Diabetic foot ulcers KW - diabetic foot infections KW - glycemic control KW - novel therapies KW - peripheral arterial disease KW - topical treatment KW - wound healing SP - 1153 EP - 1160 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 20 IS - 9 N2 - INTRODUCTION: Standard treatment for diabetic foot ulcers (DFUs) includes off-loading, debridement, moisture balance, management of infection and peripheral arterial disease (PAD) as well as adequate glycemic control. The outcomes so far are unsatisfactory. AREAS COVERED: Herein, the authors provide an outline of newer pharmacological agents for the management of DFUs and give their expert perspectives on future treatment strategies. EXPERT OPINION: Evidence-based healthcare calls for high quality evidence from large RCTs before the implementation of new guidelines for the management of DFUs. Empagliflozin and liraglutide can be recommended for glucose control in patients with DFUs and PAD, while intensive lipid lowering therapy with evolocumab when primary cholesterol goals are not met could be offered to patients with DFUs. Further clinical studies are warranted to develop a structured algorithm for the treatment of DFUs that fail to heal after four weeks of current standard of care. Sucrose octasulfate dressings, becaplermin gel, and platelet-rich plasma (PRP) could also be considered as advanced treatment options for the management of hard to heal DFUs. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/30958725/Advancing_pharmacotherapy_for_diabetic_foot_ulcers L2 - http://www.tandfonline.com/doi/full/10.1080/14656566.2019.1598378 DB - PRIME DP - Unbound Medicine ER -