Cilostazol: improving walking distance in patients with intermittent claudication

Area of Science:

• Vascular Medicine
• Pharmacology

Background:

• Intermittent claudication, a symptom of peripheral arterial disease, significantly impacts quality of life by limiting walking ability.
• Patients with intermittent claudication face increased cardiovascular risks and have limited effective medical treatment options beyond exercise.
• Surgical revascularization is only suitable for a small percentage of patients.

Purpose of the Study:

• To evaluate the efficacy and safety of cilostazol as a symptomatic treatment for intermittent claudication.
• To assess cilostazol's impact on pain-free and maximum walking distances in patients with peripheral arterial disease.

Main Methods:

• A meta-analysis of eight major, large-scale, multicenter, placebo-controlled, double-blind clinical trials involving over 2000 patients.
• Assessment of pain-free and maximum walking distances as primary efficacy endpoints.

Main Results:

• Cilostazol demonstrated significant improvements in both pain-free and maximum walking distances compared to placebo.
• The medication exhibited a favorable overall safety and tolerability profile across the studies.
• Meta-analysis confirmed the efficacy of cilostazol in managing intermittent claudication symptoms.

Conclusions:

• Cilostazol is the first approved medication shown to effectively relieve symptoms of intermittent claudication in large clinical trials.
• Administered as 100 mg twice daily, cilostazol is licensed in the UK, USA, and Japan as an adjunct to exercise for managing moderate-to-severe intermittent claudication.