Treatment of intermittent claudication with beraprost sodium, an orally active prostaglandin I2analogue

Abstract

Despite previous investigations suggesting efficacy, these results indicate that beraprost is not an effective treatment to improve symptoms of intermittent claudication in patients with PAD. The potential benefit of beraprost on critical cardiovascular events would require confirmation in a larger prospective investigation.

A Stable Prostacyclin Analogue (Iloprost) in the Treatment of Buerger^|^#8217;s Disease: A Prospective Analysis of 150 Patients

“…Mohler et al reported another double-blinded, randomized, controlled trial using beraprost sodium, an orally active prostaglandin I 2 analogue for the treatment of intermittent claudication. 19) Beraprost did not improve symptoms of intermittent claudication in patients with peripheral arterial disease.…”

“…On the other hand, the results of two randomized trials comparing oral prostacyclin derivatives with placebo in peripheral arterial disease were less impressive. 6,19) The first one was The European Thromboangiitis obliterans (Buerger's disease) study. 6) In this double blind, randomized, placebo-controlled trial, no significant difference was found between groups for the total healing of lesions.…”

“…[5][6][7] It is known that prostaglandin analogues facilitate relaxation of vascular smooth cells, inhibit platelet aggregation, and inhibit chemotaxis and cell proliferation. 19) Nicotine consumption damages vascular endothelium, which is the source of nitric oxide production. 20) Brodman et al showed that iloprost achieves a significant reduction in peripheral vascular resistance and that the vasodilatative effect is independent of nitric oxide.…”

Pheochromocytoma with the Renovascular Hyperreninemia Attendant on Renal Artery Stenosis

“…One placebo-controlled 6-month trial found that oral beraprost improved pain-free and maximal walking distance (388). Two randomized, controlled trials of 6 months' duration of patients with intermittent claudication failed to demonstrate any effect on walking distance with either oral beraprost or iloprost, although cardiovascular ischemic events were reduced in the beraprost-treated group (389). Frequent adverse effects included headache, flushing, and gastrointestinal distress.…”

Oral Buflomedil in the Prevention of Cardiovascular Events in Patients With Peripheral Arterial Obstructive Disease

“…The results obtained in previous studies also suggested that other agents with vasodilatory activities such as synthetic prostacyclin analogues may have beneficial effects not only on local symptoms but also on overall cardiovascular events. 20,23 However, these were small studies not primarily designed to evaluate vascular events. Buflomedil is an ␣-blocker with vasoactive and hemorheologic properties, 7-10,16,17 but whether it would be effective in patients already treated with other vasodilator (eg, angioten-sin-converting enzyme inhibitors or calcium blockers) or rheological (eg, cilastazol) drugs is currently unknown.…”