Tags

Type your tag names separated by a space and hit enter

Management of intermittent claudication with pentoxifylline: meta-analysis of randomized controlled trials.
CMAJ. 1996 Oct 15; 155(8):1053-9.CMAJ

Abstract

OBJECTIVE

To evaluate the efficacy of pentoxifylline therapy in improving the walking capacity of patients with moderate intermittent claudication.

DATA SOURCES

A search of MEDLINE for trials published between 1976 and 1994 inclusive, and a bibliographic review of all articles retrieved.

STUDY SELECTION

Randomized, placebo-controlled, double-blind clinical trials were selected that evaluated the pain-free walking distance (the distanced walked on a treadmill before the onset of calf pain) and the absolute claudication distance (the maximum distance walked on a treadmill) among patients with moderate intermittent claudication. Twelve study groups in 11 trials were included in the analysis.

DATA EXTRACTION

In addition to information regarding the trial design, patient characteristics, dosages and treatment periods, the means and standard deviations were collected for both the pain-free walking and absolute claudication distances. Trial quality was also assessed.

DATA SYNTHESIS

Overall, there was a statistically significant improvement in the pain-free walking distance after pentoxifylline therapy (weighted mean difference 29.4 m [95% confidence interval (CI) 13.0 to 45.9 m]); this finding was based on a total sample of 612 patients (308 in the treatment groups and 304 in the control groups). A significant improvement was also noted in the absolute claudication distance (weighted mean difference 48.4 m [95% CI 18.3 to 78.6 m]); this was based on a total sample of 511 patients (258 in the treatment group and 253 in the control group). In a sensitivity analysis of the pain-free walking distance, significant treatment effects and no statistically significant heterogeneity were found when only trials were included that were "medically eligible" (involved patients with stage II disease and a pain-free walking distance of 50 to 200 m). In a similar sensitivity analysis of the absolute claudication distance, the two conditions resulting in a significant treatment effect and no significant heterogeneity were the inclusion of "medically eligible" trials and those with a shorter treatment duration (13 weeks or less).

CONCLUSION

Pentoxifylline therapy may be efficacious in improving the walking capacity of patients with moderate intermittent claudication. However, properly conducted clinical trials are required to provide a true estimate of the benefit.

Authors+Show Affiliations

Health Analysis and Modelling Group, Social and Economic Studies Division, Statistics Canada, Ottawa, Ont.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

8873633

Citation

Hood, S C., et al. "Management of Intermittent Claudication With Pentoxifylline: Meta-analysis of Randomized Controlled Trials." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 155, no. 8, 1996, pp. 1053-9.
Hood SC, Moher D, Barber GG. Management of intermittent claudication with pentoxifylline: meta-analysis of randomized controlled trials. CMAJ. 1996;155(8):1053-9.
Hood, S. C., Moher, D., & Barber, G. G. (1996). Management of intermittent claudication with pentoxifylline: meta-analysis of randomized controlled trials. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 155(8), 1053-9.
Hood SC, Moher D, Barber GG. Management of Intermittent Claudication With Pentoxifylline: Meta-analysis of Randomized Controlled Trials. CMAJ. 1996 Oct 15;155(8):1053-9. PubMed PMID: 8873633.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of intermittent claudication with pentoxifylline: meta-analysis of randomized controlled trials. AU - Hood,S C, AU - Moher,D, AU - Barber,G G, PY - 1996/10/15/pubmed PY - 1996/10/15/medline PY - 1996/10/15/entrez SP - 1053 EP - 9 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 155 IS - 8 N2 - OBJECTIVE: To evaluate the efficacy of pentoxifylline therapy in improving the walking capacity of patients with moderate intermittent claudication. DATA SOURCES: A search of MEDLINE for trials published between 1976 and 1994 inclusive, and a bibliographic review of all articles retrieved. STUDY SELECTION: Randomized, placebo-controlled, double-blind clinical trials were selected that evaluated the pain-free walking distance (the distanced walked on a treadmill before the onset of calf pain) and the absolute claudication distance (the maximum distance walked on a treadmill) among patients with moderate intermittent claudication. Twelve study groups in 11 trials were included in the analysis. DATA EXTRACTION: In addition to information regarding the trial design, patient characteristics, dosages and treatment periods, the means and standard deviations were collected for both the pain-free walking and absolute claudication distances. Trial quality was also assessed. DATA SYNTHESIS: Overall, there was a statistically significant improvement in the pain-free walking distance after pentoxifylline therapy (weighted mean difference 29.4 m [95% confidence interval (CI) 13.0 to 45.9 m]); this finding was based on a total sample of 612 patients (308 in the treatment groups and 304 in the control groups). A significant improvement was also noted in the absolute claudication distance (weighted mean difference 48.4 m [95% CI 18.3 to 78.6 m]); this was based on a total sample of 511 patients (258 in the treatment group and 253 in the control group). In a sensitivity analysis of the pain-free walking distance, significant treatment effects and no statistically significant heterogeneity were found when only trials were included that were "medically eligible" (involved patients with stage II disease and a pain-free walking distance of 50 to 200 m). In a similar sensitivity analysis of the absolute claudication distance, the two conditions resulting in a significant treatment effect and no significant heterogeneity were the inclusion of "medically eligible" trials and those with a shorter treatment duration (13 weeks or less). CONCLUSION: Pentoxifylline therapy may be efficacious in improving the walking capacity of patients with moderate intermittent claudication. However, properly conducted clinical trials are required to provide a true estimate of the benefit. SN - 0820-3946 UR - https://www.unboundmedicine.com/medline/citation/8873633/Management_of_intermittent_claudication_with_pentoxifylline:_meta_analysis_of_randomized_controlled_trials_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=reprint&pmid=8873633 DB - PRIME DP - Unbound Medicine ER -