Sclerotherapy with 3% polidocanol foam to treat second‐degree haemorrhoidal disease: Three‐year follow‐up of a multicentre, single arm, IDEAL phase 2b trial

• Published in: Colorectal disease 2023-03, Vol.25 (3), p.386-395
• Main Authors: Gallo, Gaetano, Picciariello, Arcangelo, Pietroletti, Renato, Novelli, Eugenio, Sturiale, Alessandro, Tutino, Roberta, Laforgia, Rita, Moggia, Elisabetta, Pozzo, Mauro, Roveroni, Maurizio, Bianco, Vincenzo, Realis Luc, Alberto, Giuliani, Antonio, Diaco, Elia, Naldini, Gabriele, Trompetto, Mario, Perinotti, Roberto, D'Andrea, Vito, Lobascio, Pierluigi
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Bleeding; bleeding haemorrhoids; Follow-Up Studies; follow‐up; haemorrhoidal disease; Hemorrhoids; Hemorrhoids - drug therapy; Humans; Medical treatment; Middle Aged; Patients; Polidocanol - therapeutic use; polidocanol foam; Polyethylene Glycols - adverse effects; Polyethylene Glycols - therapeutic use; sclerofoam trial; Sclerosing Solutions - therapeutic use; Sclerotherapy; Statistical analysis; Treatment Outcome; Young Adult
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.16380

Background Sclerotherapy with 3% polidocanol foam is becoming increasingly popular for the treatment of symptomatic I–II or III degree haemorrhoidal disease (HD). However, there are no studies that have reported a follow‐up of more than 1 year. The purpose of this study was to analyse the long‐term outcomes of sclerotherapy with 3% polidocanol foam in the treatment of II–degree HD. Methods This was an open label, single‐arm, phase 2b trial conducted in 10 tertiary referral centres for HD. A total of 183 patients with II–degree HD, aged between 18 and 75 years with symptomatic HD according to the Goligher classification and unresponsive to medical treatment, were included in the study and underwent sclerotherapy with 3% polidocanol foam. The efficacy was evaluated in terms of bleeding score, haemorrhoidal disease symptom score (HDSS) and short health scale for HD (SHS–HD) score. Successful treatment was defined as the complete absence of bleeding episodes after 7 days (T1) according to the bleeding score. Results The overall success rate ranged from 95.6% (175/183) at 1 year to 90.2% (165/183) after the final 3 year follow‐up. The recurrence rate, based on the primary outcome, ranged from 12% (15/125) to 28% (35/125). The greatest increase in recurrence (15) was recorded between 12 and 18 months of follow‐up, then another five between 18 and 24 months. Both the HDSS and the SHS score remained statistically significant (p