Smart Library

Off-label adjunct to compression therapy; the evidence is one 20-patient uncontrolled series in complicated varicose veins plus case reports.

Investigational adjunctive use with only non-randomized clinical reports identified; proposed mechanisms are blood-volume removal and hirudin effects on vessels; not a substitute for pharmacotherapy.

Investigational use for symptomatic relief of grade II-III internal/external hemorrhoidal disease; does not address anatomic prolapse.

Investigational adjunctive use in primary open-angle glaucoma; weak case-series evidence. Not a substitute for IOP-lowering eye drops or surgery.

Investigational use for non-discogenic sciatica including piriformis syndrome; no controlled trial, only an old unquantified Russian case series.

Investigational adjunct, not a primary treatment; a few small, mostly uncontrolled studies report lower PASI scores.

Investigational use for localized refractory eczema; evidence is limited to a few small studies without placebo or standard-care controls.

Investigational use for keloid and hypertrophic scars; evidence is limited to one small uncontrolled series and two conflicting single-patient reports.

Investigational for category III CP/CPPS: evidence is limited to a 3-patient case report and an uncontrolled Russian series; multimodal therapy remains standard.

Investigational adjunctive use for chronic endometriosis-related pelvic pain; very limited evidence. Not a substitute for hormonal or surgical management.

Investigational for non-specific chronic pelvic pain; the only clinical report located is an uncontrolled 60-woman series in which leeches were one part of multimodal care.

Investigational for tinnitus; small non-randomized studies, mostly Russian, report less ear noise, and no study using the Tinnitus Handicap Inventory was identified.

Investigational use for mild-to-moderate carpal tunnel syndrome; only one single-patient case report and one randomized-trial protocol without results were identified.

Investigational adjunct for adult recalcitrant atopic dermatitis (EASI >21) refractory to dupilumab or JAK inhibitor; only small studies in general eczema.

Investigational adjunct for chronic plaque psoriasis recalcitrant to biologic therapy; only small, mostly uncontrolled studies, none in refractory disease.

Highly investigational use for severe nodulocystic acne refractory to isotretinoin; small Ayurvedic studies only, none in refractory disease, and scarring risk concerns.

Investigational adjunct for papulopustular rosacea with persistent inflammatory lesions; evidence is one small uncontrolled Ayurvedic study.

Investigational adjunct for hypertrophic scars (within the original wound), distinct from keloid; evidence is one small uncontrolled Russian series.

Investigational adjunct in compensated NYHA II heart failure; only small open-label or uncontrolled studies were identified, mostly in Russian-language sources; guideline-directed medical therapy remains primary.

Investigational adjunct to physical/occupational therapy in chronic post-stroke hemiplegia; no RCT support; not for acute stroke care.

Highly investigational adjunct in stable Hashimoto's thyroiditis; small uncontrolled series only; levothyroxine replacement remains primary.

Investigational extended-protocol adjunct for NIH Category III chronic prostatitis/CPPS; uncontrolled case series only; UPOINT-directed therapy remains primary.

Highly investigational extended-protocol adjunct for stable Peyronie's disease; one uncontrolled Russian series only; collagenase clostridium histolyticum and surgical correction remain primary.

Highly investigational adjunct for non-cirrhotic hepatic congestion; uncontrolled Russian series only; cirrhosis and portal hypertension are absolute exclusions.

Investigational adjunct for chronic temporomandibular joint disorder; conservative care (education, jaw exercises, occlusal splint, NSAIDs) remains first-line; specialty referral for refractory cases.

Investigational adjunct for symptomatic benign prostatic hyperplasia; alpha-blockers, 5-alpha-reductase inhibitors, and minimally invasive surgical therapy remain evidence-based.

Palliative investigational adjunct for endometrioma-related chronic pelvic pain in patients declining or unable to undergo surgical/hormonal management.

Investigational palliative adjunct for adenomyosis-related dysmenorrhea and pelvic pain; hormonal therapy (LNG-IUD, dienogest, GnRH antagonists) and (definitively) hysterectomy remain evidence-based.

Investigational adjunct for chronic refractory subjective tinnitus; cognitive behavioral therapy, sound therapy, and hearing aids for concurrent hearing loss remain evidence-based.

Investigational adjunct for chronic non-allergic rhinitis; intranasal corticosteroids, intranasal antihistamines, and trigger avoidance remain evidence-based.

Investigational adjunct for axial pain in ankylosing spondylitis; NSAIDs, biologic DMARDs (TNF and IL-17 inhibitors), and structured exercise remain evidence-based first-line therapy.

Investigational adjunct for primary burning mouth syndrome; clonazepam (topical or systemic), alpha-lipoic acid, low-dose tricyclics, and cognitive behavioral therapy remain evidence-based.