Preventive Treatment of Cerebral Transient Ischemia: Comparative Randomized Trial of Pentoxifylline versus Conventional Antiaggregants

Herskovits, E; Famulari, A.; Tamaroff, L.; González, Ana-Maria; Vázquez, A.; Domínguez, Rosa; Fraiman, H.; Vila, José Henrique Andrade

doi:10.1159/000115765

Cited by 50 publications

(16 citation statements)

References 18 publications

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“…Pentoxifylline did not influence the elevated blood pressure in these rats, but histological examination of the brains of these rats showed that drug treatment prevented activation of microglia and influx of T-lymphocytes and macrophages. A 6-month randomised clinical trial enrolling patients experiencing transient ischaemic attacks (TIAs) assigned 73 patients to asprin+dipyridamole and 65 patients to pentoxifylline 47. During the trial, there were 80 TIAs in 19 patients in the aspirin/dipyridamole group, and 19 TIAs in 9 of those receiving pentoxifylline (p<0.05).…”

Section: Pentoxifylline: Myriad Potential Benefits For Vascular Healthmentioning

confidence: 99%

Pentoxifylline for vascular health: a brief review of the literature

2016

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Pentoxifylline is a methylxanthine derivative that has been used for several decades in the symptomatic management of intermittent claudication. For reasons that remain fairly obscure, this drug benefits blood rheology in a number of complementary ways: decreasing blood and plasma viscosity, lowering plasma fibrinogen while promoting fibrinolysis, and improving blood filterability by enhancing erythrocyte distensibility and lessening neutrophil activation. Anti-inflammatory effects on neutrophils and macrophage/monocytes—some of them attributable to pentoxifylline metabolites—appear to play a mediating role in this regard. Although clinical trials with pentoxifylline have often been too small in size to reach statistically significant findings regarding impacts on hard end points, a review of the existing literature suggests that pentoxifylline may have potential for slowing the progression of atherosclerosis, stabilising plaque, reducing risk for vascular events, improving the outcome of vascular events, dampening the systemic inflammatory response following cardiopulmonary bypass, providing symptomatic benefit in angina and intermittent claudication, enhancing cerebral blood flow in patients with cerebrovascular disease while slowing progression of vascular dementia, improving prognosis in congestive heart failure, and aiding diabetes control. This safe and usually well-tolerated drug works in ways quite distinct from other drugs more commonly used for cardiovascular protection, and hence may confer complementary benefit when used in conjunction with them. Major clinical trials of adequate statistical power are now needed to confirm the scope of benefits that pentoxifylline can confer; studies evaluating hard end points in acute coronary syndrome, stroke/transient ischaemic attack and systolic heart failure might be particularly valuable.

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Section: Pentoxifylline: Myriad Potential Benefits For Vascular Healthmentioning

confidence: 99%

Pentoxifylline for vascular health: a brief review of the literature

2016

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“…Additionally, pentox ifyllin decreased viscosity and leukocyte and platelet adhe sion to endothelial cell walls [99] and promoted PGT release from endothelial cells [100,101]. In human clinical studies, it appeared more effective than aspirin in stroke prevention [ 102], Most importantly, a group from Yugoslavia evaluated 51 ESRD patients [103] who underwent a Scribner shunt as an acute access while waiting for development of a permanent access. Twenty-six received pentoxifyllin (400 mg 3 times a day) and 25 placebo.…”

Section: Antiplatelet Agentsmentioning

confidence: 99%

Pharmacologic Intervention to Prevent Hemodialysis Vascular Access Thrombosis

Diskin

Stokes

Pennell

1993

Nephron

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“…26 Several clinical studies have suggested a potential therapeutic or prophylactic efficacy of PTX in ischemic cerebrovascular disorders. 27 " 32 Our study was designed to assess the efficacy and safety of PTX on the survival, neurologic deficits, and extent of recovery after acute nonhemorrhagic stroke using a randomized, placebocontrolled, double-blind protocol.…”

mentioning

confidence: 99%

Pentoxifylline in acute nonhemorrhagic stroke. A randomized, placebo-controlled double-blind trial.

Hsu

Norris

Hogan

et al. 1988

Stroke

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The efficacy and safety of pentoxifylline were assessed in 297 adult patients with ischemic stroke in a molticenter, doable-blind, randomized and placebo-controlled trial. Treatment was started within 12 hoars after the stroke onset Study medication was administered intravenously continuously (16 mg/kg/day, maximum 1,200 mg/day) for 3 days and per os (400 mg ti.d.) for the remainder of 28 days. Demographic data were comparable, and functional impairment and mortality (pentoxifylline 12%, placebo 10%) were not different between the two groups. Neurologic deficit scores Improved from baseline admission scores during the 4-week study in both groups but did not differ between groups at admission or throughout the study except during the first few days when the consciousness level (Days 1 and 2), motor function (Days 1 and 2), cranial nerve function (Days 1-4), and total neurologic deficit scores (Days 1 and 2) were better in the pentoxifylline group than in the placebo group, especially in a subset of patients with severe deficits at admission. Laboratory values and side effects were also comparable between groups. Our study indicates that pentoxifylline can be given safely in patients with acute ischemic stroke. Although pharmacologk effects were present during the first few days, the clinical benefits were small and not sustained.

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Preventive Treatment of Cerebral Transient Ischemia: Comparative Randomized Trial of Pentoxifylline versus Conventional Antiaggregants

Cited by 50 publications

References 18 publications

Pentoxifylline for vascular health: a brief review of the literature

Pentoxifylline for vascular health: a brief review of the literature

Pharmacologic Intervention to Prevent Hemodialysis Vascular Access Thrombosis

Pentoxifylline in acute nonhemorrhagic stroke. A randomized, placebo-controlled double-blind trial.

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