Oral mesoglycan beats placebo on symptom score in acute hemorrhoidal disease trial
A 52-patient randomized trial found mesoglycan cut the Hemorrhoidal Disease Symptom Score more than placebo over 40 days, with benefits concentrated in grade III disease.
Executive Summary
- A randomized, placebo-controlled trial found that an oral endothelial-protective agent produced a greater reduction in hemorrhoidal symptom scores than placebo over six weeks of treatment.
- The benefit spanned itching, pain, and swelling, and it was more pronounced in patients with the more severe grade of disease studied.
- The trial isolated the acute treatment phase itself, a period where management has leaned on topical relief and procedural options rather than a systemic pharmacologic approach with a defined symptom endpoint.
- The trial population was small, and the sharpest gains sat within a subgroup rather than uniformly across the full randomized group, which bears on how far a single trial of this size can generalize.
The result
The aCute HaemORrhoidal MEsoglycan Study (CHORMES) tested oral mesoglycan, an agent with endothelial-protective, antithrombotic, and profibrinolytic properties, against placebo in the acute phase of hemorrhoidal disease. In the modified intention-to-treat population of 47 patients, mesoglycan produced a larger reduction in the Hemorrhoidal Disease Symptom Score than placebo from baseline to day 40: -7.5 points versus -3.9 points (P =.027). The improvement held up across sensitivity analyses and was more pronounced in patients with grade III disease specifically (P =.042). UseUse of mesoglycan in the acute phase of hemorrhoidal disease, the aCute HaemORrhoidal MEsoglycan Study (CHORMES): A double-blind, randomized controlled trial.Jul 13, 2026
How it was done
CHORMES was a multicenter, randomized, double-blind, placebo-controlled trial that enrolled adults with symptomatic grade II to III hemorrhoidal disease. Fifty-two patients were randomized 1:1 to oral mesoglycan or placebo for 40 days, with a 30-day telephone follow-up after treatment ended. The prespecified primary endpoint was the change in the Hemorrhoidal Disease Symptom Score from baseline to day 40, and the trial analyzed both a modified intention-to-treat population (n = 47) and a modified per-protocol population. UseUse of mesoglycan in the acute phase of hemorrhoidal disease, the aCute HaemORrhoidal MEsoglycan Study (CHORMES): A double-blind, randomized controlled trial.Jul 13, 2026
The symptom breakdown
Beyond the composite score, the trial reported reductions favoring mesoglycan on individual symptoms: itching (P =.0048), pain (P =.0246), and swelling or prolapse (P =.0418). Pain relief measured on a visual analog scale was sustained only in the mesoglycan arm through follow-up. In the grade III subgroup, bleeding also improved with mesoglycan (P =.03), concentrating the drug's largest effects in the more severe disease grade studied. UseUse of mesoglycan in the acute phase of hemorrhoidal disease, the aCute HaemORrhoidal MEsoglycan Study (CHORMES): A double-blind, randomized controlled trial.Jul 13, 2026
Safety and adherence
Forty-eight of the 52 randomized patients completed the study, and treatment adherence exceeded 97% in both the mesoglycan and placebo arms. No treatment-related serious adverse events were reported. The combination of high completion, high adherence, and a clean safety readout in a 40-day oral regimen supports the trial's tolerability finding, though the population size limits how precisely any rare safety signal could be detected. UseUse of mesoglycan in the acute phase of hemorrhoidal disease, the aCute HaemORrhoidal MEsoglycan Study (CHORMES): A double-blind, randomized controlled trial.Jul 13, 2026
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