New Daily Pill Reduces Lymphoedema Swelling in Major Study

Lymphoedema is a confusing condition that leaves arms or legs swollen with fluid. The lymphatic system fails to drain properly, so limbs bloat dramatically. More than 400,000 people in the UK suffer from it. No cure exists yet. Even current treatments often fail to ease symptoms enough.

Now researchers have created a daily pill that offers real relief. A study at Stanford Medicine shows patients taking acebilustat once a day for a year saw swelling drop. Skin thickness improved too. Scarring faded and quality of life rose. The drug is not approved in the UK or US right now. Scientists plan a major clinical trial to get official approval.

Lauren Scheidegger has lived with lymphoedema in her right leg since birth. This new daily pill cut the size of her affected leg by a third in just one year. She felt better after three months on the study drug. By six months, changes became very clear. 'I could start seeing the ligaments and veins on my foot,' she says. 'The definition around my ankle and knee came back.'

Her usual treatment involved heavy compression garments. She also got manual lymphatic drainage therapy. This is a specialized massage using light pressure to move fluid away from swollen areas. The heaviness and swelling built up all day. Taking acebilustat made movement easier again. 'The drug seemed to take off that overload,' she adds. But when she stopped the drug at the end of the trial, swelling returned quickly.

Some users say benefits last even after stopping the medication. Debon Cochrane is one such person. She developed lymphoedema in 1999 after surgery for ovarian cancer. Before taking the drug, managing her condition meant wearing compression garments and getting MLD massage. 'Compression garments almost cause as much problem as the condition,' says Debon, a 62-year-old nurse from California. They put pressure where it should not be. This caused bunions and ingrown toenails for her.

It took about nine months before major changes appeared. By the trial's end, her symptoms improved roughly 20 per cent. Her skin got smoother and more supple. The pill works differently than stockings or massage alone. It targets the root cause of fluid buildup inside cells.

You could feel the texture changing," she notes. Debon has gone a year and a half without her symptoms getting worse since stopping acebilustat. The pill works by blocking leukotriene B4, or LTB4. This molecule shows up at high levels in people with lymphoedema and is thought to push inflammation along.

In the early trial, researchers treated 23 patients whose legs were affected by the condition. After 12 months, limb swelling dropped by about 5 per cent. That loss equals roughly one litre of fluid. Participants also said they felt less heaviness in their limbs, noticed softer tissue, gained self-confidence, and saw an overall boost to their quality of life. The team found no major safety issues.

Senior study author Dr Stanley Rockson says the results suggest drug therapies could eventually help patients rely less on self-management techniques. His group has already started a larger trial using acebilustat in people with lymphoedema affecting their arms.

The British Lymphology Society warned that the first trial was small and had no control group. Without a placebo arm for comparison, it is hard to tell how much of the improvement came from the drug itself. Carol-Ann Barrett, a specialist practitioner for MLD UK, added that a larger randomised placebo-controlled trial would provide stronger evidence.

Professor Dominic Furniss from the British Association of Plastic, Reconstructive and Aesthetic Surgeons offered a different take. "This study shows some promise that we may have a desperately needed drug treatment for lymphoedema in future," he said.