Venoactive Drugs for Chronic Venous Disease in South Korea: An Updated Review of Clinical Trials and National Practice

Venous insufficiency Varicose veins Drugs Flavonoids Vitis viniferaVenoactive drugs are widely used to improve venous tone, reduce capillary permeability, enhance lymphatic drainage, and modulate inflammatory and oxidative pathways.This review aimed to summarize recent clinical and experimental research published since 2020 regarding venoactive drugs currently available in South Korea.Recent metaanalyses and large observational studies continue to support MPFF as the most evidencebased VAD, demonstrating significant improvement in edema, symptoms, quality of life, and venous hemodynamics.Diosmin monotherapy shows clinical benefits but remains less effective than MPFF.VVSE has emerged as an important VAD in Korea, with recent randomized controlled trials.Troxerutin and calcium dobesilate show moderate evidence for edema reduction and microcirculatory improvement, although calcium dobesilate requires monitoring due to rare agranulocytosis.Naftazone remains widely used in Korea despite limited evidence.Centella asiatica demonstrates vascular protective effects but currently has low-level clinical evidence.Ruscus extract combination therapy such as Cyclo 3 fort has strong international evidence but is not yet available in Korea.In conclusion, while MPFF remains the most evidence-based therapy globally, the Korean prescribing pattern differs due to National Health Insurance reimbursement policies and domestic clinical research, particularly supporting VVSE.Recent Korean clinical trials have contributed significantly to the evidence base for VAD therapy, and future research should focus on comparative effectiveness studies and combination therapy strategies.