Studies on the Effectiveness and Safety of Cilostazol, Beraprost Sodium, Prostaglandin E₁ for the Treatment of Intermittent Claudication

Abstract

To study the eŠectiveness for the treatment of intermittent claudication (IC) of three drugs with antiplatelet eŠects, cilostazol, beraprost sodium, and prostaglandin E 1 (PGE 1 ), by using a systemic review of literature and a meta-analysis. A search was undertaken for studies reported between 1966-2002 in the MEDLINE database, and references in published articles and reviews were obtained. Data for maximum walking distance (MWD), pain-free walking distance (PFWD), and adverse clinical events were extracted from the articles that met the inclusion criteria. .92], respectively. These diŠerences were statistically signiˆcant between the test drugs and placebo. However there was no statistical signiˆcance diŠerence between beraprost sodium and placebo, even though there was one study that showed a tendency for improvement in walking distance. The total rate of adverse clinical events in cilostazol and beraprost sodium was higher than that for placebo, while there was no statistical signiˆcant diŠerence between PGE 1 and placebo, although PGE 1 had a higher tendency for adverse clinical events. The literature evaluation results and the meta-analysis suggest that these two drugs (cilostazol and PGE 1 ) can be considered to be eŠective drugs for the treatment of IC. Due to current availability of only a few clinical reports, further studies are needed to clarify the e‹cacy of beraprost sodium in the treatment of IC.

Beraprost sodium versus clopidogrel for preventing vascular thromboembolic events of arteriovenous fistula in uraemic patients: a retrospective study with a mean 3-year follow-up

“…This can improve vasospasm of the radial artery, increase blood flow of an internal fistula, and promote maturation of an internal fistula. 31,32…”

“…Prostaglandin E 1 also has the effects of inhibiting platelet aggregation, protecting vascular endothelial cells, and preventing atherosclerosis. 31,32 Additionally, prostaglandin E 1 has an obvious targeting distribution to damaged vessels. This can improve vasospasm of the radial artery, increase blood flow of an internal fistula, and promote maturation of an internal fistula.…”

“…This can improve vasospasm of the radial artery, increase blood flow of an internal fistula, and promote maturation of an internal fistula. 31,32 Thrombosis is the major cause of failure of arteriovenous fistulas in patients on haemodialysis. 8,14 Formation of vortices induced by vascular intimal injury at the anastomotic site promotes adhesion of monocyte macrophages, which exacerbates the vicious cycle of fibrosis and atherosclerosis.…”

A randomized trial of iloprost in patients with intermittent claudication

“…13 For intermittent claudication, prostacyclin, PGE-1 and a PGE-1 prodrug, delivered intravenously for 4-8 weeks, have been reported to increase ACD and ICD. [14][15][16][17][18][19][20][21][22][23] Intravenous delivery of drugs, often for several hours, is neither feasible nor practical in patients with intermittent claudication, but an oral formulation of prostacyclin offers the possibility of symptomatic improvement without the inconvenience of intravenous therapy.…”

A systematic review and economic evaluation of cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease.

“…[35][36][37][38][39][40][41][42][43][44][45][46] No additional RCTs were identified from these excluded reviews. Twenty-six RCTs 34, were included in this review.…”