Urokinase therapy improves diabetic foot ulcers healing and decreases CV events in diabetes patients

Diabetic foot ulcer (DFU) is a disabling complication of diabetes mellitus. Here, we attempted to assess whether long-term intrafemoral artery infusion of low-dose urokinase therapy improved Diabetic foot ulcers and decreased cardiovascular events in patients with Diabetic foot ulcers. Diabetic foot ulcers were randomized to continuous intrafemoral thrombolysis or conventional therapy groups. The continuous intrafemoral thrombolysis group received continuous intrafemoral urokinase injection for 7 days, and conventional therapy just received wound debridement and dressing change. Then, a follow-up of average 6.5 years was performed.

Results: Compared with conventional therapy, at the first 1 month of intervention stage, the ulcers achieved a significant improvement in continuous intrafemoral thrombolysis group including a complete closure (72.4% vs 17.5%), an improved ulcer (27.6% vs 25.8%), unchanged or impaired ulcer (0% vs 56.7%). During the 6.5-year follow-up, for the primary outcome of ulcer closure rate, continuous intrafemoral thrombolysis therapy obtained a better complete healing rate. For the secondary outcome of cardiovascular disease events, continuous intrafemoral thrombolysis therapy had a lower incidence of cardiovascular events. Importantly, intrafemoral thrombolysis therapy decreased the incidence of cardiovascular death (HR 0.42 Additionally, continuous intrafemoral thrombolysis therapy improved local skin oxygenation, peripheral neuropathy, and glycolipid metabolic profiles compared to conventional therapy group (p<0.05). Continuous intrafemoral thrombolysis therapy has a better therapeutic efficacy to improve Diabetic foot ulcers and decrease cardiovascular events.

Reference:

Tong J, Zhang J, Xiang L, Li S, Xu J, Zhu G, Dong J, Cheng Y, Ren H, Liu M, Yue L, Xiang G. Continuous intrafemoral artery infusion of urokinase improves diabetic foot ulcers healing and decreases cardiovascular events in a long-term follow-up study. BMJ Open Diabetes Res Care. 2024 Jan 12;12(1):e003414. doi: 10.1136/bmjdrc-2023-003414. PMID: 38216296.