Venous insufficiency is a major cause of leg ulcers, and treatment of these ulcers is often difficult. Compression is the primary therapy. Previous reports have suggested benefits from adjuvant treatment with low-dose aspirin (Lancet 1994; 344:164), pentoxifylline (Cochrane Database Syst Rev 2012; 12:CD001733), and most recently, topical beta-blockers (J Am Acad Dermatol 2013; 69:e204). Simvastatin has been shown to have potential benefit for wound healing in animal studies.
These authors performed a double-blind, placebo-controlled trial of simvastatin 40 mg in 66 patients with uninfected ulcers smaller than 10 cm in diameter. Simvastatin was given for 10 weeks with compression; patients were seen every 2 weeks. Results were analyzed for ulcers ≤5 cm and >5 cm. Five patients dropped out. Overall, 72% of simvastatin-treated ulcers healed versus 32% in the control group. Ulcers ≤5 cm had better responses (100% with simvastatin and 46% with control) than larger ulcers. There were no differences in toxicity between the two groups.
Evangelista MT et al. Simvastatin as a novel therapeutic agent for venous ulcers: A randomized, double-blind, placebo-controlled trial. Br J Dermatol 2014 Feb 7; [e-pub ahead of print].
Jeffrey P. Callen, MD