A comparison of cilostazol and pentoxifylline for treating intermittent claudication

Dawson, David L.; Cutler, Bruce S.; Hiatt, William R.; Hobson, Robert W.; Martin, John D.; Bortey, Enoch; Forbes, William; Strandness, D. Eugene

doi:10.1016/s0002-9343(00)00569-6

Cited by 373 publications

(239 citation statements)

References 15 publications

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“…126 Cilostazol was superior to placebo in most studies performed to date. Dawson et al 128 compared the efficacy and safety of cilostazol (100 mg twice daily) to pentoxifylline (400 mg 3 times daily) in patients with intermittent claudication. After 24 weeks, cilostazol significantly increased walking distance compared with pentoxifylline and placebo.…”

mentioning

confidence: 99%

Peripheral Artery Disease: Current Insight Into the Disease and Its Diagnosis and Management

Olin

Sealove

2010

Mayo Clinic Proceedings

268

183

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mentioning

confidence: 99%

Peripheral Artery Disease: Current Insight Into the Disease and Its Diagnosis and Management

Olin

Sealove

2010

Mayo Clinic Proceedings

268

183

View full text Add to dashboard Cite

“…The first drug that obtained approval was pentoxifyllin, nowadays rarely used due to recent study results about doubts on its efficacy. 11 Cilostazol, a phosphodiesterase type III inhibitor, has recently been evaluated in trials that have documented an increased walking ability and improved quality of life. 12,13 This class of drugs is, however, contraindicated in patients with heart failure.…”

Section: Discussionmentioning

confidence: 99%

Sarpogrelate, a 5-HT2A receptor antagonist in intermittent claudication. A Phase II European study

Norgren

Jawień

Mátyás³

et al. 2006

Vasc Med

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This was a multinational, multicentre, double-blind Phase II study in Europe to evaluate the efficacy and safety of two dose regimens (200 mg bid and 200 mg tid) of sarpogrelate (MCI-9042, 5-HT2A receptor antagonist) compared to placebo in patients with stable, moderately severe intermittent claudication. Following a single-blind placebo run-in period of 6 weeks, 364 (309 male and 55 female) patients (59.2 ± 8.4 years, mean SD) were randomized to receive sarpogrelate 200 mg bid, 200 mg tid or placebo for 24 weeks with a follow-up of 8 weeks. The primary objective was the increase of absolute claudication distance (ACD) at the end of treatment (week 24) compared to placebo. Analysis of covariance (ANCOVA) was performed on the log-transformed percentage of baseline ACD: loge (ACD/baseline). A responder analysis (defined as a 50% improvement in ACD) was also performed. There was a marked training/placebo effect on the ACD which persisted up to 16 weeks. At 24 weeks the primary objective did not reach statistical significance (200 mg bid vs placebo, p = 0.225; 200 mg tid vs placebo, p = 0.580). In the responder analysis, 200 mg bid showed a statistically significant difference vs placebo ( p = 0.035). In the exploratory analysis with completers (patients completing all treadmill tests), there was a statistical difference in ACD/baseline change for 200 mg bid ( p = 0.035) and in the responder analysis for 200 mg tid ( p = 0.044) at 24 weeks compared to placebo. Both treatments showed a carry-over effect for ACD during the 8-week follow-up (weeks 28-32). The treatment was well tolerated and no clinically significant safety concerns were reported. In conclusion, the study results confirm that sarpogrelate is well tolerated and although the primary endpoint failed to reach statistical significance, the responder analysis showed an increased absolute walking distance, which makes a further trial warranted, including a larger population, and possibly also a longer treatment period.

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“…Its anti-claudication effect has been inconsistent. A study randomizing 698 patients with IC to cilostazol, pentoxifylline or placebo did not observe any difference between pentoxifylline and placebo (Dawson et al 2000). ACC/AHA guidelines recommend using pentoxifylline as an alternative in patients who cannot tolerate cilostazol or in whom cilostazol is contraindicated.…”

Section: Pharmacological Agentsmentioning

confidence: 97%

Lower Extremity Peripheral Arterial Disease

Sharma¹,

Aronow²

2012

Traditional and Novel Risk Factors in Atherothrombosis

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A comparison of cilostazol and pentoxifylline for treating intermittent claudication

Cited by 373 publications

References 15 publications

Peripheral Artery Disease: Current Insight Into the Disease and Its Diagnosis and Management

Peripheral Artery Disease: Current Insight Into the Disease and Its Diagnosis and Management

Sarpogrelate, a 5-HT2A receptor antagonist in intermittent claudication. A Phase II European study

Lower Extremity Peripheral Arterial Disease

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