Treatment of chronic diabetic foot ulcers with bemiparin:: a randomized, triple-blind, placebo-controlled, clinical trial

Aims To assess the efficacy and safety of bemiparin in the treatment of chronic diabetic foot ulcers. Methods A triple-blind, parallel, randomized, placebo-controlled trial. Patients aged > 8 years, with diabetes for at least 3 years, and with a foot ulcer persisting for > 3 months were selected from 39 Spanish centres. Bemiparin 3500 IU/day for 10 days, followed by 2500 IU/day for up to 3 months plus standard care for ulcers, was compared with placebo plus standard care for ulcers for 3 months. The primary efficacy end-point was ulcer improvement, defined as an objective decrease in ulcer area of >= 50%, measured by digital photography and ImageJ software, and/or any decrease in Wagner's ulcer grade at 3 months. Results Ulcer improvement rates were 70.3% (26 of 37 patients) in the bemiparin group and 45.5% (15 of 33 patients) in the placebo group [absolute difference 24.8; 95% confidence interval (CI 2.3, 47.3; P = 0.035] (nurnber needed to treat 4; 95 % CI 2, 43). Coiriplete healing rates at 3 months were similar in both groups (35.1% vs. 33.3%; P = 0.874), as were the number of adverse events. Conclusions Bemiparin is more effective than placebo in the management of diabetic foot ulcers and has few side-effects.