Sulonex (sulodexide) / Alfasigma - LARVOL DELTA

Treatment of livedoid vasculopathy with sulodexide: A prospective study of 35 cases. (PubMed, J Dtsch Dermatol Ges) - "Our study demonstrates that sulodexide monotherapy is a clinically effective and well-tolerated therapeutic option for patients with LV. Adjunctive JAK inhibitor therapy, when clinically indicated, may yield superior therapeutic outcomes."

Journal • Thrombosis

Venous Thrombosis Prophylaxis after Endovenous and Open Surgery for Varicose Veins: A Systematic Review and Network Meta-Analysis. (PubMed, Vasc Endovascular Surg) - "Furthermore, network meta-analysis revealed no significant differences in the incidence of thromboembolic events or bleeding risk across various prophylaxis durations (3, 5, and 10 days) or among different anticoagulants, including low-molecular-weight heparin (LMWH), rivaroxaban, heparin, apixaban, and sulodexide.ConclusionsPostoperative anticoagulant prophylaxis for VTE following varicose vein surgery appears to be safe; however, its effectiveness in reducing VTE incidence remains uncertain. The lack of significant differences in outcomes across different prophylaxis durations and anticoagulant types highlights the need for further high-quality, large-scale randomized controlled trials to establish the optimal prophylactic strategy, including the appropriate agent, dosage, and duration."

Journal • Retrospective data • Review • Cardiovascular • Hematological Disorders • Thrombosis • Varicose Veins • Venous Thromboembolism

Pharmacological support strategies following endovenous laser ablation in patients with varicose veins (PubMed, Khirurgiia (Mosk)) - "EVLA provides clinical improvement and reductions in inflammatory biomarkers, but the effect is less durable in advanced disease. MPFF primarily modulates MCP-1 and VEGF, while sulodexide acts on MMP-2 and MMP-9. Their combination shows complementary pathogenetic mechanisms, yielding the most durable biochemical and clinical benefits, and may represent the optimal pharmacological support for EVLA in patients with severe chronic venous disease."

Biomarker • Journal • Varicose Veins • MMP2 • MMP9

Sulodexide can ameliorates renal interstitial fibrosis in adenine-induced kidney injury rats. (PubMed, Eur J Pharmacol) - "The study demonstrated that SDX can delay renal interstitial fibrosis in adenine-induced kidney injury rats, which may be related to the inhibition of Wnt/β-catenin signaling pathway."

Journal • Preclinical • Fibrosis • Immunology • Renal Disease • WNT3A

Oral Sulodexide Downregulates Biomarkers of Endothelial Dysfunction Among Convalescent COVID-19 Patients (ASH 2024) - "No significant differences were observed between groups for P-selectin, fibrinogen, VCAM-1, or ICAM-1 levels.ConclusionsIn this study, patients with cardiometabolic risk factors who were in a convalescent phase from moderate or severe COVID-19 within 40 days of clinical presentation exhibit elevated serum levels of biomarkers indicative of ongoing endothelial cell activation and dysfunction. Patients receiving sulodexide for eight weeks showed a reduction in TM, vWF, D-dimer, CRP, and IL-6 serum levels compared to placebo, suggesting a potential protective effect against thromboinflammation and endothelial damage.These findings may translate into improved clinical outcomes, though further studies are needed to confirm these results and explore their long-term implications."

Biomarker • Clinical • Cardiovascular • Diabetes • Genetic Disorders • Hypertension • Infectious Disease • Inflammation • Metabolic Disorders • Novel Coronavirus Disease • Obesity • Respiratory Diseases • ICAM1 • IL6 • VCAM1

Chronic Cardiovascular Disorders Associated With COVID-19: A Literature Review. (PubMed, Cureus) - "Promising but still experimental methods, such as endothelial-protective agents like sulodexide and targeting inflammatory pathways, need thorough testing...They include higher healthcare use, long-term disability, and economic costs. This situation requires increased clinical attention and proactive cardiovascular monitoring for those recovering from COVID-19."

Journal • Review • Cardiovascular • Fibrosis • Hematological Disorders • Hypertension • Immunology • Infectious Disease • Inflammation • Novel Coronavirus Disease • Pediatrics • Respiratory Diseases • Thrombosis

Exacerbation of Psoriatic Lesions and Vascular Complications in a Patient Treated with Bimekizumab: A Case Report (EADV 2025) - "Between 2020 and 2023, the patient received methotrexate (15–25 mg/week, orally and subcutaneously), resulting in improvement of joint symptoms but no significant effect on nail involvement...Topical corticosteroids and systemic cyclosporine A provided no significant improvement...Sulodexide was initiated on January 21, 2025, followed by the introduction of oral acitretin (35 mg/day; 0.35 mg/kg) resulting in partial improvement, including slight initial improvement of acral skin involvement... Although rare, cases of vasculitis have been described with other IL-17 inhibitors. A similar mechanism may underlie the adverse effects observed with bimekizumab in this patient. Further research is needed to better understand these associations and to develop personalized treatment strategies that account for individual risk of adverse reactions."

Case report • Clinical • Dermatology • Hidradenitis Suppurativa • Immunology • Inflammatory Arthritis • Psoriasis • Psoriatic Arthritis • Rheumatology • Seronegative Spondyloarthropathies • Vasculitis • IL17A

A Novel Marine Bacterium-Derived Heparinase with High Potential for the Structure-Function Studies of Heparin/Heparan Sulfate. (PubMed, J Agric Food Chem) - "This property enables HD1492 to reveal the distribution and composition of nonsulfated domains in HP/HS─overcoming the limitation of conventional disaccharide analysis─as validated in mouse organ-derived GAGs and the drug sulodexide. Overall, the unique enzymatic properties of HD1492 confer innovative value that distinguishes it from terrestrial heparinases, providing a much-needed tool for the resolution of HP/HS structural and functional domains and the development and quality control of related products."

Journal

Clinicopathological Characteristics and Prognosis of IgA Nephropathy Combined With Malignant Hypertension Kidney Injury. (PubMed, J Clin Lab Anal) - "This study revealed that in IgAN-MHT patients, a higher proportion of glomerulosclerosis was independently associated with poorer renal outcomes, while the use of sulodexide showed a significant independent association with improved renal function."

Journal • Cardiovascular • Glomerulonephritis • Hypertension • IgA Nephropathy • Lupus Nephritis • Nephrology • Renal Disease

Protection of the Endothelium and Endothelial Glycocalyx by Albumin and Sulodexide in Porcine Model of Kidney Transplant. (PubMed, Exp Clin Transplant) - "We suggest that albumin and sulodexide may offer beneficial effects in preserving endothelial function during kidney transplant. The potential for these agents to enhance graft survival and improve kidney transplant outcomes warrants further investigation."

Biomarker • Journal • Preclinical • Cardiovascular • Chronic Kidney Disease • Nephrology • Reperfusion Injury • Transplantation • SDC1

Clinical study on the effect of glycosaminoglycans on vascular endothelial glycocalyx in sepsis (PubMed, Zhonghua Wei Zhong Bing Ji Jiu Yi Xue) - "Early glycocalyx degradation can occur in sepsis patients. GAG have a protective effect on,the vascular endothelium, reducing the severity of sepsis and providing organ protection. HS, CRP, APTT, IL-6, APACHE II score, SOFA score, and ISTH score are independent predictive factors for the prognosis of sepsis patients. The combination of HS and the above indicators can significantly improve the accuracy of prediction."

Journal • Cardiovascular • Critical care • Hematological Disorders • Infectious Disease • Oncology • Septic Shock • Thrombosis • CRP • IL6 • SDC1 • TNFA

Letter: Urticarial Vasculitis Triggered by Sulodexide in an Elderly Patient with Renal Impairment: A Case Report. (PubMed, Dermatitis) - No abstract available

Journal • Dermatology • Immunology • Renal Disease • Urticaria • Vasculitis

Efficacy and safety of Sulodexide in sepsis induced coagulation: a single-center, randomized, controlled, single-blind clinical study (ChiCTR) - P4 | N=202 | Not yet recruiting | Sponsor: The First Hospital of Jilin University; The First Hospital of Jilin University

New P4 trial • Infectious Disease • Septic Shock

Profiling of endothelial dysfunction biomarkers in long COVID syndrome (ISTH 2025) - "Results Patients (n=103 treatment group and n=103 reference group) administered with an orally active form of glycosaminoglycans (GAGs, sulodexide) for 8 weeks exhibited a reduction in endothelial dysfunction biomarkers such as TM, vWF, D-dimer, CRP, and IL-6 levels compared to reference group, suggesting a protective effect on the release of biomarkers associated with thromboinflammation and endothelial damage. No significant differences were observed between the groups for P-selectin, fibrinogen, VCAM-1, or ICAM-1 levels."

Biomarker • Cardiovascular • Infectious Disease • Inflammation • Novel Coronavirus Disease • Respiratory Diseases • CRP • ICAM1 • IL6 • VCAM1

Modulating Endothelial Thromboinflammation Biomarkers in Diabetic Convalescent COVID-19 Patients (ISTH 2025) - "Aims This study assesses the impact of Sulodexide on key serum biomarkers in convalescent diabetic COVID-19 patients...No significant differences were noted for P-selectin, VCAM-1, or ICAM-1 levels. Table or Figure Upload"

Biomarker • Clinical • Cardiovascular • Diabetes • Infectious Disease • Inflammation • Metabolic Disorders • Novel Coronavirus Disease • CRP • ICAM1 • IL6 • VCAM1

Endothelial Protection in Convalescent COVID-19 Patients (clinicaltrials.gov) - P4 | N=2 | Terminated | Sponsor: Pirogov Russian National Research Medical University | N=30 ➔ 2 | Recruiting ➔ Terminated; Lack of the eligible patients

Biomarker • Enrollment change • Trial termination • Cardiovascular • Hematological Disorders • Infectious Disease • Inflammation • Novel Coronavirus Disease • Thrombosis • ICAM1

A meta-analysis of efficacy and safety of sulodexide in the prevention and treatment of venous thromboembolism (PubMed, Zhonghua Yi Xue Za Zhi) - "Moreover, the incidence of bleeding events was lower in patients treated with sulodexide compared to those treated with other traditional anticoagulants [0.8% (2/251) vs 6.1% (40/656), RR=0.11, 95%CI: 0.03-0.37, P<0.001]. Sulodexide exhibits favorable efficacy and safety for VTE prevention in high-risk populations and recurrence reduction in VTE patients."

Clinical • Journal • Retrospective data • Cardiovascular • Venous Thromboembolism

Sulodexide in Controlling the Recurrence of Psoriasis (clinicaltrials.gov) - P3 | N=160 | Enrolling by invitation | Sponsor: Xijing Hospital

New P3 trial • Dermatology • Immunology • Psoriasis

"The Role of Venoactive Compounds in the Treatment of Chronic Venous Disease". (PubMed, J Vasc Surg Venous Lymphat Disord) - "The existing scientific evidence provides a strong rationale for incorporating VACs into a comprehensive treatment plan for CVD, alongside established interventional therapies and non-interventional approaches like compression, to optimize patient outcomes and improve quality of life."

Journal • Review • Inflammation • Pain • Venous Ulcer

UTILITY OF VENOACTIVE COMPOUNDS IN POST-THROMBOTIC SYNDROME: A SYSTEMATIC REVIEW. (PubMed, J Vasc Surg Venous Lymphat Disord) - "This systematic review found that VACs had at least moderate quality of evidence in improving venous symptoms, decreasing edema, and accelerating venous ulcer healing. Two pilot RCTs of higher quality suggested usefulness of diosmin and MPFF as adjunctive treatment to rivaroxaban therapy to reduce the incidence of PTS and improve deep vein recanalization. Since most RCTs were published over two decades ago, and several lacked the required precision in reporting, new high quality, low bias RCTs are needed to assess the role of specific VACs for both prevention and treatment of PTS."

Journal • Review • Cardiovascular • Hematological Disorders • Thrombosis • Venous Ulcer

Advances in sulodexide-based long-term anticoagulation for a myasthenia gravis patient with giant thymoma. (PubMed, Front Pharmacol) - "Emergency endotracheal intubation was performed, and he was then transferred to the intensive care unit (ICU) and treated with immunoglobulin, plasmapheresis, prednisone, and pyridostigmine. SDX demonstrated excellent efficacy and safety, with no adverse effects observed during the 3-year follow-up period. In conclusion, SDX should be considered an ideal potential option for long-term anticoagulation in patients with complex conditions such as MG with both thrombotic and bleeding risks."

Journal • Review • Cardiovascular • CNS Disorders • Critical care • Hematological Disorders • Myasthenia Gravis • Pulmonary Embolism • Respiratory Diseases • Solid Tumor • Thrombocytopenia • Thymoma • Thymus Cancer

Retrospective analysis of the effectiveness and safety of sulodexide for venous thromboembolism prevention in neurosurgical patients. (PubMed, Neurosurg Rev) - "Sulodexide in combination with routine VTE prophylaxis effectively reduces the risk of VTE in neurosurgical patients. A high baseline GCS score is a protective factor for VTE, whereas length of hospital stay is a risk factor for VTE."

Journal • Retrospective data • Cardiovascular • Venous Thromboembolism

Analysis of the prognostic efficacy of syndecan-1 for patients with ACLF and its functional role in liver regeneration. (PubMed, BMC Med) - "Collectively, our findings suggest that SDC-1 represents a potential prognostic and therapeutic target for ACLF and should be further investigated."

Journal • Gastroenterology • Gastrointestinal Disorder • Hepatology • Inflammation • Liver Failure • Septic Shock • Transplantation • JAK1 • SDC1

Comprehensive management application of sulodexide on proteinuria: 2 case reports. (PubMed, Front Med (Lausanne)) - "Case 2 is a 52 years-old female with chronic nephritis and rheumatoid arthritis accompanied by persistent proteinuria and edema in both legs. Two patients showed a decrease in urinary protein levels and stable control of the remaining signs of disease after the addition of sulodexide to their comprehensive treatment regimens, indicating that sulodexide plays an important role in the comprehensive management of proteinuria."

Journal • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Hypertension • Immunology • Inflammatory Arthritis • Metabolic Disorders • Nephrology • Renal Disease • Rheumatoid Arthritis • Rheumatology • Type 2 Diabetes Mellitus

The modulation of endothelial glycocalyx by sulodexide on the porcine model of enzymatic endothelial glycocalyx damage - a pilot study. (PubMed, Clin Hemorheol Microcirc) - "The results of the study demonstrated a working model of EG damage but no specific action of sulodexide on EG modulation. In the sublingual microcirculation analysis, the sulodexide reduced the fall in absolute tissue perfusion in 60 min."

Journal • Preclinical • SDC1