American Society of Hirudotherapy

Knowledge Coverage Map

What ASH covers — and what remains open — across organ systems and evidence tiers.

Last Updated: May 27, 2026Reviewed by: Andrei Dokukin, MD
Coverage analytics — institutional referenceAuto-updates as registries grow

ASH organizes its clinical knowledge into structured registries. This page is a live map: as new conditions, compounds, and trials are added, the counts and category distribution update automatically. There are no hand-maintained numbers.

Conditions by evidence tier

199 total conditions across three tiers. Honest framing: most off-label uses are Tier C investigational.

3Tier A

FDA-cleared

K040187: venous congestion in surgical flaps. The only formally FDA-cleared use of medicinal leech therapy.

10Tier B

Off-label with RCT support

Off-label uses with at least one RCT or systematic review. Common candidates: knee OA, chronic venous insufficiency, certain dermatology.

+ 5 more

186Tier C

Investigational

Mechanistic rationale, case series, small pilots. Includes many conditions that mainstream medicine has not researched.

+ 181 more

Coverage by organ system

Cross-walk to clinical-specialties pages. Numbers reflect the conditions registry.

Musculoskeletal

35

Tier A: 0 · Tier B: 4 · Tier C: 31

+ 31 more in this category

Dermatological

41

Tier A: 0 · Tier B: 0 · Tier C: 41

+ 37 more in this category

Neurological

37

Tier A: 0 · Tier B: 2 · Tier C: 35

+ 33 more in this category

What's still open

The 10,000-article target means current coverage is the foundation, not the destination. Major gaps actively being prioritized:

  • Translational pipeline depth: Each compound entry needs detailed drug-development trajectory (preclinical → FDA pathway → clinical context).
  • Pediatric protocols: Limited registry coverage; weight-based dosing absent in current literature.
  • Geographic regulatory survey: Many African, Oceanian, and Caribbean jurisdictions remain "unregulated" — honest marker, but needs ground-truth verification.
  • Recent RCT digestion (2024-2026): Continuous PubMed surveillance for new trials in OA, microsurgery, integrative pain medicine.
  • Translation parity: RU/ES/DE locales need ongoing medical-grade editorial pass across all 36 namespaces.

Researchers and clinicians can contribute via the Contact & Transparency page.

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.