Safety and efficacy of cilostazol in the management of intermittent claudication

Figures & data

Table 1 Pharmacotherapies tested for intermittent claudication therapy

Prostaglandin analogs Antiplatelets Serotonin blockers Vasodilators Naftidrofuryl L-Arginine Levocarnitine and propionyl levocarnitine Immunomodulation therapy Antimicrobial therapy Phosphodiesterase inhibitors

Figure 1 Cilostazol biochemical composition.

Table 2 Beneficial effects of cilostazol

Inhibits platelet activation and aggregation Reduces thrombosis Inhibits smooth muscle cell contraction Inhibits smooth muscle cell proliferation Increases limb blood flow Increases plasma high density lipoprotein-cholesterol levels Reduces plasma triglyceride levels Potentiates angiogenesis Reduces inflammation

Figure 2 Mean percent change in maximal walking distance over time among intermittent claudication patients randomized to cilostazol 100 mg 2×/day (n = 227), pentoxifylline 400 mg 3×/day (n = 232), or placebo (n = 239) for 24 weeks. MWD = maximal walking distance. Reprinted from Dawson, DL, Cutler BS, Hiatt WR, et al 2000. A comparison of cilostazol and pentoxifylline for treating intermittent claudication. Am J Med, 109:523–30. Copyright © 2000, with permission from Elsevier.

Figure 3 Mean percent change in maximal walking distance (MWD) among intermittent claudication patients receiving cilostazol 100 mg 2×/day (n = 140), cilostazol 50 mg 2×/day (n = 139), or placebo (n = 140) for 24 weeks. Reprinted from Beebe, HG, Dawson DL, Cutler BS, et al 1999. A new pharmacological treatment for intermittent claudication: results of a randomized, multicenter trial. Arch Intern Med, 159:2041–50. Copyright © 1999 with permission from American Medical Association.

Figure 4 Mean absolute change in maximal walking distance (MWD), as measured by graded or constant-load protocols, among intermittent claudication patients receiving cilostazol 100 mg 2×/day, cilostazol 50 mg 2×/day, or placebo in six randomized controlled trials. Reprinted from Regensteiner JG, Ware JE Jr, McCarthy WJ, et al 2002. Effect of cilostazol on treadmill walking, community-based walking ability, and health-related quality of life in patients with intermittent claudication due to peripheral arterial disease: meta-analysis of six randomized controlled trials. J Am Geriatr Soc, 50:1939–46. Copyright © 2002 with permission from Blackwell Publishing.

Figure 5 Mean improvement in maximal walking distance following medical interventions in patients with claudication. Reprinted from Milani RV, Lavie CJ. 2007. The role of exercise training in peripheral arterial disease. Vasc Med, 12:351–8. Copyright © 2007 with permission from Sage Publishing.

DawsonDLCutlerBSHiattWR2000A comparison of cilostazol and pentoxifylline for treating intermittent claudicationAm J Med1095233011063952

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BeebeHGDawsonDLCutlerBS1999A new pharmacological treatment for intermittent claudication: results of a randomized, multicenter trialArch Intern Med15920415010510990

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RegensteinerJGWareJEJrMcCarthyWJ2002Effect of cilostazol on treadmill walking, community-based walking ability, and health-related quality of life in patients with intermittent claudication due to peripheral arterial disease: meta-analysis of six randomized controlled trialsJ Am Geriatr Soc5019394612473004

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