Efficacy of Medicinal Leech Therapy in Diverse Clinical Applications: A Comprehensive Study from Azerbaijan
Farzali S, Yaraliyeva S, Huseynov F, Manafov A, Saglam N (2025) · Turkiye Parazitolojii Dergisi · n=181
Perfil del estudio
- Diseño
- single-center prospective observational cohort study of hirudotherapy across 11 clinical indications (Herba Medical Center, Baku, Azerbaijan; treatment period 2020-2024)
- Tamaño de la muestra (n)
- 181
- Intervención
- Disposable medicinal leeches (Hirudo medicinalis) from hygienic Ministry of Ecology and Natural Resources-approved farms; treatment frequency tailored to disease severity (daily, every 3 days, or weekly)
- Comparador
- No randomized comparator - within-subject pre/post comparison and Pearson correlation between conditions
- Punto final primario
- Treatment success rate by clinical condition, calculated based on post-treatment examinations, patient feedback, and physician evaluations
- Resultado primario
- Overall success rate 82.68 ± 29.25%; 100% success in osteoarthritis pain (n=50), lipoma (n=8), Raynaud disease (n=3), scleroderma (n=2); high success in thyroiditis (94.44%, n=18), Baker's cyst (80%, n=25), ear diseases (80%, n=10), diabetic foot ulcers (80%, n=5); moderate in eye diseases (75%, n=20); lowest in varicose veins (33.33%, n=30)
- Duración del seguimiento
- post-treatment evaluation at session completion
- PMID
- 40923484
Hallazgos clave
- Largest single-center Azerbaijani cohort of hirudotherapy across 11 clinical indications (n=181, 2020-2024)
- Highest reported success rates for osteoarthritis pain (100%, n=50) - consistent with the broader European OA RCT evidence base
- Lowest success rate for varicose veins (33%) - contrasts with the optimistic Kalender 2014 Turkish RCT
- Demonstrated operational feasibility of disposable leech protocol with Ministry-approved hygienic sourcing
- Adds the post-Soviet/Caucasian geography to the international leech therapy evidence base
Limitaciones
- Observational cohort with no randomized comparator - severe confounding-by-indication risk
- Patient-reported and physician-judged 'success' lacks standardized validated outcome measures
- Single private medical center - selection bias toward CAM-favorable patients
- Heterogeneous indications with small per-condition samples (n=2-50)
- No standardized adverse-event reporting protocol described
Implicaciones clínicas
Farzali 2025 is the largest published Azerbaijani hirudotherapy cohort and provides useful real-world utilization data spanning 11 clinical indications. For ASH editorial purposes, the study is cited only as cross-cultural utilization evidence rather than as RCT-level efficacy data. The reported 100% success rate for OA pain is consistent with the European RCT body, while the low varicose-vein success (33%) is a clinically meaningful caution for that indication. The Caucasian geography fills a previously underrepresented region in the hirudotherapy literature.
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