American Society of Hirudotherapy

Smart Library

Faceted search across all 5 registries. Filter by registry type, evidence level, or safety domain.

Curated knowledge libraryReference collection

New to hirudotherapy? Start here

This library indexes the full evidence base. For orientation, begin with the core guides:

RCTs

137

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

Leech therapy for symptomatic treatment of knee osteoarthritis: results and implications of a pilot study

GRADE very low

Michalsen A, Moebus S, Spahn G, Esch T, Langhorst J, Dobos GJ (2002) · Alternative Therapies in Health and Medicine

Insufficient evidence

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

Effect of taleeq (leech therapy) in dawali (varicose veins)

GRADE very low

Nigar Z, Alam MA (2011) · Ancient Science of Life

Cohort / case series

Efficacy of leech therapy in the management of osteoarthritis (Sandhivata)

GRADE very low

Rai PK, Singh AK, Singh OP, Rai NP, Dwivedi AK (2011) · Ayu

Cohort / case series

Medicinal leeches and the microsurgeon: a four-year study, clinical series and risk benefit review

GRADE low

Whitaker IS, Josty IC, Hawkins S, Azzopardi E, Naderi N, Graf J, Damaris L, Lineaweaver WC, Kon M (2011) · Microsurgery

Cohort / case series

Medicinal leeches for surgically uncorrectable venous congestion after free flap breast reconstruction

GRADE very low

Pannucci CJ, Nelson JA, Chung CU, Fischer JP, Kanchwala SK, Kovach SJ, Serletti JM, Wu LC (2014) · Microsurgery

Cohort / case series

Hirudotherapy for limb ischemia in the pediatric intensive care unit: a retrospective observational cohort

GRADE very low

Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A (2023) · Frontiers in Pediatrics

Cohort / case series

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

A systematic review and meta-analysis of medical leech therapy for osteoarthritis of the knee

GRADE moderate

Lauche R, Cramer H, Langhorst J, Dobos G (2014) · The Clinical Journal of Pain

Meta-analysis

The efficacy and safety of medical leech therapy for osteoarthritis of the knee: A meta-analysis of randomized controlled trials

GRADE moderate

Wang H, Zhang J, Chen L (2018) · International Journal of Surgery

Meta-analysis

Chemical and mechanical alternatives to leech therapy: a systematic review and critical appraisal

GRADE low

Azzopardi EA, Whitaker IS, Rozen WM, Naderi N, Kon M (2011) · Journal of Reconstructive Microsurgery

Meta-analysis

Conservative treatment of thumb base osteoarthritis: a systematic review

GRADE low

Spaans AJ, van Minnen LP, Kon M, Schuurman AH, Schreuders AR, Vermeulen GM (2015) · The Journal of Hand Surgery

Meta-analysis

Medicinal leech therapy in pain syndromes: a narrative review

GRADE very low

Koeppen D, Aurich M, Rampp T (2013) · Wiener Medizinische Wochenschrift

Clinical guideline

Controversy: hirudotherapy (leech therapy) as an alternative treatment for osteoarthritis

GRADE very low

Gunawan F, Wibowo YR, Bunawan NC, Turner JH (2015) · Acta Medica Indonesiana

Clinical guideline

Medicinal leech therapy in venous congestion and various ulcer forms: Perspectives of Western, Persian and Indian medicine

GRADE very low

Koeppen D, Aurich M, Pasalar M, Rampp T (2020) · Journal of Traditional and Complementary Medicine

Clinical guideline

Efficacy of Medicinal Leech Therapy in Diverse Clinical Applications: A Comprehensive Study from Azerbaijan

GRADE very low

Farzali S, Yaraliyeva S, Huseynov F, Manafov A, Saglam N (2025) · Turkiye Parazitolojii Dergisi

Cohort / case series

Clinical Efficacy of Leech Therapy (Ta'liq al-'Alaq) in Eczema (Nar Farsi): An Open-Label Single-Arm Clinical Study

GRADE very low

Ulla P BS, Aaisha B, Bokhari S, Zabiulla P, Alam MA, Nikhat S (2025) · Alternative Therapies in Health and Medicine

Cohort / case series

Prophylactic versus reactive leech therapy for venous congestion after fingertip replantation: A retrospective comparative study and literature review

GRADE low

Kameda Y, Motomiya M, Watanabe N, Ota M, Iwasaki N (2025) · JPRAS Open

Cohort / case series

Standardized protocol for artery-only fingertip replantation

GRADE low

Buntic RF, Brooks D (2010) · The Journal of Hand Surgery

Cohort / case series

Hirudotherapy in Wound Healing

GRADE very low

Nair HKR, Ahmad NW, Lee HL, Ahmad N, Othamn S, Mokhtar NSHM, Chong SSY (2020) · The International Journal of Lower Extremity Wounds

Cohort / case series

Determining the appropriate number and duration of leech therapy in congested tissues using tissue spectrophotometry and laser Doppler flowmetry

GRADE low

Rothenberger J, Petersen W, Schaller HE, Held M (2016) · Wound Repair and Regeneration

Cohort / case series

Infections Associated with Treatment with Hirudo medicinalis - Report of Two Cases and Review of the Literature

GRADE very low

Reese K, Gümbel D, Seifert J, Daeschlein G, Napp M, Ekkernkamp A (2015) · Handchirurgie, Mikrochirurgie, plastische Chirurgie

Cohort / case series

Do that to me one more time! What kind of trial replications do we need?

GRADE very low

Lüdtke R (2008) · Complementary Therapies in Medicine

Clinical guideline

Hirudo (Leech) for proliferative vitreous retinopathy: A protocol for systemic review and meta-analysis

GRADE very low

Huang H, Lei R, Li Y, Huang Q, Gao N, Zou W (2021) · Medicine (Baltimore)

Clinical guideline

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

Analgesic effect of medicinal leeches in chronic diseases

GRADE very low

Aminov R (2025) · Annals of Parasitology

Cohort / case series

The role of leech water sampling in choice of prophylactic antibiotics in medical leech therapy

GRADE very low

Wilmer A, Slater K, Yip J, Carr N, Grant J (2013) · Microsurgery

Cohort / case series

Leech Me Alone! Atraumatic Hemarthrosis after Hirudotherapy

GRADE very low

Curcio J, Lloyd CM (2020) · Cureus

Case report

Low-Level Antimicrobials in the Medicinal Leech Select for Resistant Pathogens That Spread to Patients

GRADE very low

Beka L, Fullmer MS, Colston SM, Nelson MC, Talagrand-Reboul E, Walker P, Ford B, Whitaker IS, Lamy B, Gogarten JP, Graf J (2018) · mBio

Mechanistic

HIRUDOTHERAPY IN RECONSTRUCTIVE SURGERY: CASE-REPORTS AND REVIEW

GRADE very low

Heinz P, Tvrdý P, Pink R, Dvořák Z, Michl P (2020) · Acta Chirurgiae Plasticae

Expert consensus

Hirudotherapy (medicinal leeches) for treatment of upper airway obstruction in a dog

GRADE very low

Trenholme HN, Masseau I, Reinero CR (2021) · Journal of Veterinary Emergency and Critical Care

Case report

Hirudins and hirudin-like factors in Hirudinidae: implications for function and phylogenetic relationships

GRADE very low

Müller C, Haase M, Lemke S, Hildebrandt JP (2016) · Parasitology Research

Mechanistic

Diversity of hirudin and hirudin-like factor genes in the North-African medicinal leech, Hirudo troctina

GRADE very low

Ahmed RB, Abilov A, Müller C (2024) · Parasitology Research

Mechanistic

Monomeric and Oligomeric Decorsins of the Asian Medicinal Leech

GRADE very low

Tolksdorf C, Wolf R, Rauch BH, Jedlitschky G, Müller C (2025) · International Journal of Molecular Sciences

Mechanistic

Molecular Insights into Leech-Derived Bioactive Compounds: Biochemical Mechanisms and Therapeutic Potential

GRADE very low

Raghavi S, Deva Darshini B, Saravanan KM, Anbarasu K (2026) · International Journal of Molecular Sciences

Mechanistic

Novel Sodium Channel Inhibitor From Leeches

GRADE very low

Wang G, Long C, Liu W, Xu C, Zhang M, Li Q, Lu Q, Meng P, Li D, Rong M, Sun Z, Luo X, Lai R (2018) · Frontiers in Pharmacology

Mechanistic

In-depth profiles of bioactive large molecules in saliva secretions of leeches determined by combining salivary gland proteome and transcriptome data

GRADE very low

Liu Z, Tong X, Su Y, Wang D, Du X, Zhao F, Wang D, Zhao F (2019) · Journal of Proteomics

Mechanistic

Salivary transcriptome of the North American medicinal leech, Macrobdella decora

GRADE very low

Min GS, Sarkar IN, Siddall ME (2010) · Journal of Parasitology

Mechanistic

Leech (Hirudo medicinalis) Therapy for the Treatment of Nipple-Areolar Complex Congestion Following Breast Reduction

GRADE very low

Freeman M, Carney M, Matatov T, Vemula R, Babycos C (2015) · Eplasty

Case report

Compromised breast flap treated with leech therapy, hyperbaric oxygen, pentoxifylline and topical nitroglycerin: A case report

GRADE very low

Moffat AD, Weaver LK, Tettelbach WH (2015) · Undersea & Hyperbaric Medicine

Case report

Showing first 50 of 137. Refine filters to narrow results.

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.

Smart Library — Faceted Search Across All Registries | ASH