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Pentoxifylline and intermittent claudication: review of clinical trials and cost-effectiveness analyses.
J Cardiovasc Pharmacol. 1995; 25 Suppl 2:S44-50.JC

Abstract

Intermittent claudication (IC) is common in the elderly; the prevalence is approximately 6% in 50- to 60-year-old patients and 10-20% in those over the age of 70. Several risk factors, especially smoking, are associated with increased prevalence. Disease progression results in increasingly debilitating and costly surgical intervention for about 20% of patients. This report reviews findings from some of the clinical studies that demonstrated the efficacy of pentoxifylline, the only U.S.-approved medical therapy for IC. Findings from a recently published cost-effectiveness analysis are presented. IC is difficult to study clinically because pain is both variable and subjective. In two multicenter, randomized, placebo-controlled studies, carefully monitored treadmill testing showed that pentoxifylline-treated patients had significantly improved walking distances even in the presence of a placebo effect. The pentoxifylline effect was pronounced in patients from a clinical target population defined by low baseline resting pressure ratios (< or =0.8) and long disease duration (> 1 year). To understand the social implications of these findings, treadmill distances were converted to comparable distances on flat ground. Improvements on pentoxifylline therapy translate to walking distances that enable greater daily function. This improvement has significant practical benefit to the quality of life of IC patients. Using Medicare expenditure data, it was found that pentoxifylline therapy reduced average hospital costs per patients by $1,173. Direct medical cost savings of $69 to $3,090 were suggested by sensitivity analyses. In analyses of practical aspects of walking distance as well as cost-effectiveness analyses, pentoxifylline appears to be a highly useful treatment for IC.

Authors+Show Affiliations

Quintiles Transnational Corporation, Research Triangle Park, North Carolina, 27709-3979, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

8699861

Citation

Gillings, D B.. "Pentoxifylline and Intermittent Claudication: Review of Clinical Trials and Cost-effectiveness Analyses." Journal of Cardiovascular Pharmacology, vol. 25 Suppl 2, 1995, pp. S44-50.
Gillings DB. Pentoxifylline and intermittent claudication: review of clinical trials and cost-effectiveness analyses. J Cardiovasc Pharmacol. 1995;25 Suppl 2:S44-50.
Gillings, D. B. (1995). Pentoxifylline and intermittent claudication: review of clinical trials and cost-effectiveness analyses. Journal of Cardiovascular Pharmacology, 25 Suppl 2, S44-50.
Gillings DB. Pentoxifylline and Intermittent Claudication: Review of Clinical Trials and Cost-effectiveness Analyses. J Cardiovasc Pharmacol. 1995;25 Suppl 2:S44-50. PubMed PMID: 8699861.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pentoxifylline and intermittent claudication: review of clinical trials and cost-effectiveness analyses. A1 - Gillings,D B, PY - 1995/1/1/pubmed PY - 1995/1/1/medline PY - 1995/1/1/entrez SP - S44 EP - 50 JF - Journal of cardiovascular pharmacology JO - J. Cardiovasc. Pharmacol. VL - 25 Suppl 2 N2 - Intermittent claudication (IC) is common in the elderly; the prevalence is approximately 6% in 50- to 60-year-old patients and 10-20% in those over the age of 70. Several risk factors, especially smoking, are associated with increased prevalence. Disease progression results in increasingly debilitating and costly surgical intervention for about 20% of patients. This report reviews findings from some of the clinical studies that demonstrated the efficacy of pentoxifylline, the only U.S.-approved medical therapy for IC. Findings from a recently published cost-effectiveness analysis are presented. IC is difficult to study clinically because pain is both variable and subjective. In two multicenter, randomized, placebo-controlled studies, carefully monitored treadmill testing showed that pentoxifylline-treated patients had significantly improved walking distances even in the presence of a placebo effect. The pentoxifylline effect was pronounced in patients from a clinical target population defined by low baseline resting pressure ratios (< or =0.8) and long disease duration (> 1 year). To understand the social implications of these findings, treadmill distances were converted to comparable distances on flat ground. Improvements on pentoxifylline therapy translate to walking distances that enable greater daily function. This improvement has significant practical benefit to the quality of life of IC patients. Using Medicare expenditure data, it was found that pentoxifylline therapy reduced average hospital costs per patients by $1,173. Direct medical cost savings of $69 to $3,090 were suggested by sensitivity analyses. In analyses of practical aspects of walking distance as well as cost-effectiveness analyses, pentoxifylline appears to be a highly useful treatment for IC. SN - 0160-2446 UR - https://www.unboundmedicine.com/medline/citation/8699861/Pentoxifylline_and_intermittent_claudication:_review_of_clinical_trials_and_cost_effectiveness_analyses_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=8699861.ui DB - PRIME DP - Unbound Medicine ER -