Oral vasoactive medication in intermittent claudication: utile or futile?

Backer, Tine L. De; Stichele, Robert Vander; Warie, H. H.; Bogaert, M. G.

doi:10.1007/s002280000114

Cited by 37 publications

(14 citation statements)

References 15 publications

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“…The results were contradictory and in general modest. In the latest systematic review 51 , only 2 of 18 trials were of acceptable quality, providing very modest and statistically insignificant results for PFWD (n=150, 15m, -5-35 and n=40, -30m, -138-78 and for MWD (n=150, 21m, -10-52, and n=40, 69m,-44-182). In 2002, 4 new trials appeared on the use of pentoxifylline for IC, all performed by the same group [53][54][55][56] .…”

Section: Drugs With Limited And/or Doubtful Evidencementioning

confidence: 99%

“…As a consequence, the 300 and 600 mg forms have been withdrawn from the market, the 150 mg dosage is kept with the only indication of IC 48 Given the limited evidence on efficacy and the narrow therapeutic range, the present benefit-risk ratio of buflomedil is considered as marginal. With pentoxifylline several RCTs have been performed and there are at least 4 reviews on its use in IC [49][50][51][52] . The trials were of varying quality.…”

Section: Drugs With Limited And/or Doubtful Evidencementioning

confidence: 99%

See 1 more Smart Citation

Silence of the Limbs: Pharmacological Symptomatic Treatment of Intermittent Claudication

Backer

Stichele²,

Buyzere³

et al. 2010

CVP

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Several oral "vasoactive" drugs claim to increase walking capacity in patients with intermittent claudication (IC). Naftidrofuryl, cilostazol, buflomedil, and pentoxifylline are the most studied molecules. Although spanning several decades, several studies underlying these claims were not properly designed, underpowered or showed clinically doubtful outcomes. The evidence for these "vasoactive" drugs has always been received with scepticism, creating the need for systematic reviews and metaanalyses. This brief review discusses the benefit-risk assessment of vasoactive drugs, by applying a systematic review to evaluate randomized, placebo-controlled trials.

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Section: Drugs With Limited And/or Doubtful Evidencementioning

confidence: 99%

Section: Drugs With Limited And/or Doubtful Evidencementioning

confidence: 99%

Silence of the Limbs: Pharmacological Symptomatic Treatment of Intermittent Claudication

Backer

Stichele²,

Buyzere³

et al. 2010

CVP

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“…[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.…”

Section: Quantity and Quality Of Research Availablementioning

confidence: 99%

“…Outcomes may also have been affected by the lack of a 2-to 6-week placebo run-in. 34,38,58 Inositol nicotinate Overall, studies of inositol nicotinate scored well for most CRD quality assessment items but very poorly for the EMA items. This reflects the age of the studies and is likely to introduce a considerable degree of inaccuracy to the study findings.…”

Section: Pentoxifyllinementioning

confidence: 99%

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.

Squires

Simpson²,

Meng³

et al. 2011

Health Technol Assess

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“…Nach Diagnose einer Claudicatio intermittens kommt es nur bei einem Viertel der Patienten zu einer progredienten Verschlechterung, die schließlich bei 1-3,3% aller Claudicatiopatienten eine größere Amputation erfordert (Norgren et al 2007 (Radack und Wyderski 1990, Girolami et al 1999, De Backer et al 2000, Hiatt 2002. Wesentlich größer ist das Morbiditäts-und Mortalitätsrisiko durch die häufig gleichzeitig bestehende koronare Herzkrankheit oder andere kardiovaskuläre Krank-heiten.…”

Section: Durchblutungsfördernde Mittelunclassified

Arzneiverordnungs-Report 2010

Schwabe¹,

Paffrath²

2010

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Oral vasoactive medication in intermittent claudication: utile or futile?

Abstract: A national consensus conference, based on this review, concluded that health resources should be allocated to prevention and rehabilitation of intermittent claudication rather than to reimbursement of these products with doubtful efficacy.

Cited by 37 publications

References 15 publications

Silence of the Limbs: Pharmacological Symptomatic Treatment of Intermittent Claudication

Silence of the Limbs: Pharmacological Symptomatic Treatment of Intermittent Claudication

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.

Arzneiverordnungs-Report 2010

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