American Society of Hirudotherapy

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RCTs

17

Effectiveness of leech therapy in osteoarthritis of the knee: a randomized, controlled trial

GRADE moderate

Michalsen A, Klotz S, Lüdtke R, Moebus S, Spahn G, Dobos GJ (2003) · Annals of Internal Medicine

RCT

Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial

GRADE low

Michalsen A, Lüdtke R, Cesur Ö, Afra D, Musial F, Baecker M, Fink M, Dobos GJ (2008) · Pain

RCT

The Effectiveness of Leech Therapy in Chronic Low Back Pain

GRADE low

Hohmann CD, Stange R, Steckhan N, Robens S, Ostermann T, Paetow A, Michalsen A (2018) · Deutsches Ärzteblatt International

RCT

Effectiveness of leech therapy in chronic lateral epicondylitis: a randomized controlled trial

GRADE low

Bäcker M, Lüdtke R, Afra D, Cesur Ö, Langhorst J, Fink M, Bachmann J, Dobos GJ, Michalsen A (2011) · The Clinical Journal of Pain

RCT

Effectiveness of topical gel of medical leech (Hirudo medicinalis) saliva extract on patients with knee osteoarthritis: a randomized clinical trial

GRADE very low

Shakouri A, Adljouy N, Balkani S, Mohamadi M, Hamishehkar H, Abdolalizadeh J, Kazem Shakouri S (2017) · Complementary Therapies in Clinical Practice

RCT

Randomised controlled trial with medical leeches for osteoarthritis of the knee

GRADE low

Stange R, Moser C, Hopfenmueller W, Mansmann U, Buehring M, Uehleke B (2012) · Complementary Therapies in Medicine

RCT

Efficacy and safety of topical hirudin (Hirudex): a double-blind, placebo-controlled study

GRADE low

Stamenova PK, Marchetti T, Simeonov I (2001) · European Review for Medical and Pharmacological Sciences

RCT

Assessment of leech therapy for knee osteoarthritis: a randomized study

GRADE moderate

Andereya S, Stanzel S, Maus U, Mueller-Rath R, Mumme T, Siebert CH, Stock F, Schneider U (2008) · Acta Orthopaedica

RCT

Comparisons of medicinal leech therapy with venous catheterization in the treatment of venous congestion of the sural flap

GRADE low

Mozafari N, Ghazisaidi MR, Hosseini SN, Abdolzadeh M (2010) · Microsurgery

RCT

Study of the effect of leeching on plasma endothelin and soluble interleukin-2 receptor in patients with systemic lupus erythematosus

GRADE very low

Cheng SP, Liu JL, Yuan J (2005) · Chinese Journal of Integrative Medicine

RCT

Hirulog in the treatment of unstable angina. Results of the Thrombin Inhibition in Myocardial Ischemia (TIMI) 7 trial

GRADE moderate

Fuchs J, Cannon CP (1995) · Circulation

RCT

Comparison of the effectiveness of medicinal leech and TENS therapy in the treatment of primary osteoarthritis of the knee: a randomized controlled trial

GRADE low

Isik M, Ugur M, Yakisan RS, Sari T, Yilmaz N (2017) · Zeitschrift für Rheumatologie

RCT

Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial

GRADE low

Abtahi-Forooshani MS, Roozbehani S, Fatemi M, Noori A (2026) · Health Science Reports

RCT

Bivalirudin in patients undergoing primary angioplasty for acute myocardial infarction (HORIZONS-AMI): 1-year results of a randomised controlled trial

GRADE high

Mehran R, Lansky AJ, Witzenbichler B, Guagliumi G, Peruga JZ, Brodie BR, Dudek D, Kornowski R, Hartmann F, Gersh BJ, Pocock SJ, Wong SC, Nikolsky E, Gambone L, Vandertie L, Parise H, Dangas GD, Stone GW (2009) · The Lancet

RCT

Impact of Bivalirudin on Ischemia/Reperfusion Injury in Patients with Reperfused STEMI Assessed by Cardiac Magnetic Resonance

GRADE low

Zhang Y, Zou Z, Xu B, Chen B, Ge H, Ding S, Pu J (2024) · Pharmaceuticals

RCT

Safety of Bivalirudin Combined with Ticagrelor in the Emergency PCI in Patients with Acute ST-Segment Elevation Myocardial Infarction

GRADE low

Wang ZD, Chen YX, Liu M, Li P, Liang XW, Zhu XZ, Xie WC, Liao W (2022) · Clinical and Applied Thrombosis/Hemostasis

RCT

Prospective Randomized Pilot Study Comparing Bivalirudin Versus Heparin in Neonatal and Pediatric Extracorporeal Membrane Oxygenation

GRADE low

McMichael A, Weller J, Li X, Hatton L, Zia A, Raman L (2024) · Pediatric Critical Care Medicine

RCT

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.

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