Clinical effects of intravenous iloprost in patients with intermittent claudication

Müller-Bühl, U; Diehm, Curt; Krais, T.; Zimmermann, Rainer; Mörl, H; Eckstein, H.‐H.

doi:10.1007/bf00544555

Cited by 12 publications

(3 citation statements)

References 11 publications

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“…Prostaglandins have also shown clinical benefit in reducing the symptoms of intermittent claudication and significant increase in walking distance 23,24). PGI 2 which is synthesized in vascular endothelial and smooth muscle cells, shows antiplatelet action and vasodilating action 4,5).…”

Section: Discussionmentioning

confidence: 99%

Effects of Beraprost Sodium on Subjective Symptoms in Diabetic Patients with Peripheral Arterial Disease

et al. 2013

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BackgroundThis study evaluated the effects of Beraprost sodium (Berasil) on subjective leg symptoms in patients with peripheral arterial disease caused by diabetes mellitus.MethodsNinety-four diabetic patients with peripheral arterial disease were treated with Beraprost in a fixed-dose, prospective, multicenter, cohort study. Beraprost (40 µg) was administered orally 3 times daily (120 µg/day) for 12 weeks. We developed a new disease-specific symptom questionnaire, which evaluated the effect of peripheral arterial disease on leg discomfort in daily life and assessed therapeutic responses to treatment. Patients were asked for their subjective assessment of symptoms on a written questionnaire before treatment and after 12 weeks of therapy.ResultsThere was significant improvement in all estimated subjective symptoms (burning, coldness, edema, exertional pain, stabbing, and paresthesias) in the lower extremities at 12 weeks (p < 0.001). There were 18 patients with neuropathy in whom significant improvement was noted for 6 subjective symptoms at 12 weeks (p < 0.05). Adverse events considered to be drug-related were observed in 4 patients (4.3%), all of which were mild and resolved with discontinuation of the medication.ConclusionsBeraprost is effective as a treatment for improving various subjective symptoms in the lower extremities, such as burning, coldness, edema, exertional pain, stabbing, and paresthesias, in diabetic patients with peripheral arterial disease.

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Section: Discussionmentioning

confidence: 99%

Effects of Beraprost Sodium on Subjective Symptoms in Diabetic Patients with Peripheral Arterial Disease

et al. 2013

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“…Use of prostaglandins is limited by the necessity to treat patients by intravenous infusions; the use of alprostadil is further limited by its widespread systemic side effects (Elkeles et al 1969;Mitchell 1981). In the few placebo-controlled trials of epoprostenol or its analogues that have been performed, no improvements in walking capacity were seen (Hay et al 1987;Muller-Buhl et al 1987). Interestingly, in contrast to results in arteriosclerosis, iloprost may have a place in the treatment of rest pain in thromboangiitis obliterans, Buerger's disease (Fiessinger & Schafer 1990).…”

Section: Prostaglandinsmentioning

confidence: 99%

Pharmacological Approaches to the Treatment of Intermittent Claudication???

1992

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Intermittent claudication is a common condition of the elderly, occurring in 3 to 20% of individuals over the age of 65 years. Although local disease is usually benign, life expectancy in patients with intermittent claudication is reduced by approximately 10 years due to associated cardiovascular mortality. Several classes of drugs have been used in intermittent claudication, but clinical studies evaluating their efficacy leave much to be desired. Pentoxifylline (oxpentifylline), a rheological agent, and naftidrofuryl, an enhancer of aerobic metabolism, are the 2 most widely investigated and utilised drugs. The combined results of 10 placebo-controlled studies with pentoxifylline and 4 with naftidrofuryl estimate increases in claudication distances of 51 and 42%, respectively. However, due to publication bias, these figures are probably overestimates of the true benefit from treatment with these drugs. It is likely that any benefit from pentoxifylline or naftidrofuryl is small and of little clinical importance. The suggestion that naftidrofuryl has greater efficacy in older patients remains unproven. Other classes of drugs including vasodilators, antiplatelet drugs, anticoagulants and prostaglandins have not been shown to be effective. Only 2 approaches to the management of intermittent claudication have been shown convincingly to be of benefit: stopping smoking and exercising regularly.

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“…2 Prostaglandins are well established in the pharmacologic treatment of critical limb ischemia (PAD stage III/IV according to Fontaine), but they, especially prostaglandin E 1 (PGE 1 ), have also shown clinical benefit in reducing the symptoms of intermittent claudication. [3][4][5][6][7][8][9][10][11][12][13][14][15] However, the therapeutic benefit of different prostaglandins in intermittent claudication in relation to each other has until now not been well defined. Since most studies were performed with PGE 1 , the aim of the present meta-analysis, in contrast to that published by Reiter et al, 16 was to focus on the efficacy and tolerability of PGE 1 in comparison to other prostaglandins and placebo.…”

Section: Introductionmentioning

confidence: 99%

PGE1 and Other Prostaglandins in the Treatment of Intermittent Claudication: A Meta-analysis

Amendt

2005

Angiology

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In intermittent claudication, pharmacologic drugs and invasive measures are indicated in patients who do not benefit from exercise training. To evaluate the therapeutic role of prostaglandins (PGs), especially of prostaglandin E1 (PGE1), for this indication, the author performed a meta-analysis of all published prospective, randomized, controlled clinical studies in which descriptive sample statistics of the pain-free walking distance (PFWD) and the maximum walking distance (MWD) were available. In total, 9 studies with PGE1 and 4 studies with other PGs (beraprost, iloprost, AS-013) that met these selection criteria could be analyzed. In patients treated with PGE1 (n = 344), PFWD increased significantly (p < 0.001) more (+107%) than in patients treated with other PGs (n = 402; +42%) or placebo (n = 470; +24%). Similar results were also found for the MWD. Side effects were significantly (p < 0.001) fewer with PGE1 therapy than with other PGs (14.0% vs 30.8% of patients). In conclusion, PGE1 proved to be the most effective and best tolerated of the PGs evaluated.

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Clinical effects of intravenous iloprost in patients with intermittent claudication

Cited by 12 publications

References 11 publications

Effects of Beraprost Sodium on Subjective Symptoms in Diabetic Patients with Peripheral Arterial Disease

Effects of Beraprost Sodium on Subjective Symptoms in Diabetic Patients with Peripheral Arterial Disease

Pharmacological Approaches to the Treatment of Intermittent Claudication???

PGE1 and Other Prostaglandins in the Treatment of Intermittent Claudication: A Meta-analysis

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