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A randomized trial of iloprost in patients with intermittent claudication.
Vasc Med. 2008 Feb; 13(1):5-13.VM

Abstract

Prostanoids, which promote vasodilation and reduce platelet aggregation, have been proposed as candidate therapies for intermittent claudication due to peripheral arterial disease (PAD). However, studies of these medications have yielded inconsistent results. This study tested the hypothesis that iloprost, an oral prostacyclin analogue, would improve walking distance and quality of life in patients with intermittent claudication. The study was a multi-center, randomized, double-blind, placebo-controlled trial comparing three doses of oral iloprost (50 microg, 100 microg, or 150 microg twice daily), pentoxifylline, or placebo in 430 patients with intermittent claudication. The primary outcome measure was improvement in absolute claudication distance (ACD) after 6 months. Secondary outcomes included initial claudication distance and quality of life assessment. Placebo increased ACD by 3.3%, and iloprost increased peak ACD by 7.7%, 8.8% and 11.2% at the 50 microg, 100 microg, and 150 microg twice-daily doses, respectively (all insignificant relative to placebo). Pentoxifylline increased ACD by 13.9% relative to placebo (p = 0.039). Neither iloprost nor pentoxifylline enhanced quality of life. These results indicate that oral iloprost is not effective in improving exercise performance or quality of life in patients with PAD who have intermittent claudication.

Authors+Show Affiliations

Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. mcreager@partners.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18372433

Citation

Creager, Mark A., et al. "A Randomized Trial of Iloprost in Patients With Intermittent Claudication." Vascular Medicine (London, England), vol. 13, no. 1, 2008, pp. 5-13.
Creager MA, Pande RL, Hiatt WR. A randomized trial of iloprost in patients with intermittent claudication. Vasc Med. 2008;13(1):5-13.
Creager, M. A., Pande, R. L., & Hiatt, W. R. (2008). A randomized trial of iloprost in patients with intermittent claudication. Vascular Medicine (London, England), 13(1), 5-13. https://doi.org/10.1177/1358863X07084910
Creager MA, Pande RL, Hiatt WR. A Randomized Trial of Iloprost in Patients With Intermittent Claudication. Vasc Med. 2008;13(1):5-13. PubMed PMID: 18372433.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized trial of iloprost in patients with intermittent claudication. AU - Creager,Mark A, AU - Pande,Reena L, AU - Hiatt,William R, PY - 2008/3/29/pubmed PY - 2008/8/16/medline PY - 2008/3/29/entrez SP - 5 EP - 13 JF - Vascular medicine (London, England) JO - Vasc Med VL - 13 IS - 1 N2 - Prostanoids, which promote vasodilation and reduce platelet aggregation, have been proposed as candidate therapies for intermittent claudication due to peripheral arterial disease (PAD). However, studies of these medications have yielded inconsistent results. This study tested the hypothesis that iloprost, an oral prostacyclin analogue, would improve walking distance and quality of life in patients with intermittent claudication. The study was a multi-center, randomized, double-blind, placebo-controlled trial comparing three doses of oral iloprost (50 microg, 100 microg, or 150 microg twice daily), pentoxifylline, or placebo in 430 patients with intermittent claudication. The primary outcome measure was improvement in absolute claudication distance (ACD) after 6 months. Secondary outcomes included initial claudication distance and quality of life assessment. Placebo increased ACD by 3.3%, and iloprost increased peak ACD by 7.7%, 8.8% and 11.2% at the 50 microg, 100 microg, and 150 microg twice-daily doses, respectively (all insignificant relative to placebo). Pentoxifylline increased ACD by 13.9% relative to placebo (p = 0.039). Neither iloprost nor pentoxifylline enhanced quality of life. These results indicate that oral iloprost is not effective in improving exercise performance or quality of life in patients with PAD who have intermittent claudication. SN - 1358-863X UR - https://www.unboundmedicine.com/medline/citation/18372433/A_randomized_trial_of_iloprost_in_patients_with_intermittent_claudication_ L2 - http://journals.sagepub.com/doi/full/10.1177/1358863X07084910?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -