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Anti-inflammatory drug effective for treating lymphedema symptoms

Ever since Hanson was diagnosed in her teens, the only available treatment has been to wear compression garments; use the electric pump, which moves the excess fluidfrom her leg back into the bloodstream; or get massage therapy to suppress the swelling, which can occur throughout the body. She has done all of this religiously for decades.

“It’s been a lot of work and a lot of burden putting the compression socks on daily,” Hanson said. “It’s hard to get them on and off. They’re tight and they’re heavy. I’ve used the pump every night sometimes for up to four hours.”

As many as 10 million Americans and hundreds of millions of people worldwide suffer from the condition, many from the aftereffects of cancer treatments. Thirty percent of women treated for breast cancer get lymphedema, usually as a result of radiation treatment and lymph node removal, according to the American Cancer Society.

Years ago, Rockson, a physician-scientist who has treated thousands of patients with lymphedema, began to suspect that inflammation was a root cause of the disease. To test his theory, he created a mouse model for lymphedema — the disease would manifest in the animals’ tails — and treated it with ketoprofen, a nonsteroidal anti-inflammatory drug, or NSAID.

“It reversed the lymphedema,” Rockson said. “We saw tremendous improvement in the structural abnormalities in the skin.”

To test ketoprofen in humans, Rockson conducted two pilot trials, which are both discussed in the paper. The first trial had 21 participants who knew they were getting the drug and took it orally for four months. Researchers performed skin biopsies at the beginning of the trial and then four months later at the end of the trial as a measurement of disease severity.

“That was an extremely positive trial,” Rockson said. “We saw a tremendous reversal in the disease process in the skin and dramatic reductions in skin thickness.” This led to the second double-blind, placebo-controlled study with 34 participants. Hanson, who participated in the second trial, didn’t know at first whether she was taking ketoprofen or a placebo. But she felt fairly certain after two months that she was getting ketoprofen.

“After a couple of months, I remember going home one day and taking my compression stockings off and looking at my leg thinking, ‘Wow my skin is wrinkly, that’s so weird.’ The skin wasn’t so taut or thick. It was more like normal,” Hanson said.

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