[Vasoactive agents and prostanoids in the therapy of PAD: facts, questions, disproven assumptions]

In the view of the AkdA (Drug Committee of the German Medical Profession), the efficacy in intermittent claudication is currently proven only for Naftidrofuryl, whereas in the opinion of the DGA (German Society of Angiology) also that of prostaglandin E(1) is proven. Both drugs are indicated if neither walking exercise nor vascular or endovascular reconstruction are feasible. In critical limb ischaemia (Fontaine stage III/IV), the efficacy of prostaglandin E(1) and iloprost is proven according to both the treatment recommendations of the DGA and the ACC/AHA Guidelines. The AkdA also agrees with the administration of prostanoids, even though it considers their efficacy not sufficiently proven in accordance with CPMP criteria. Here, prostaglandin E(1) is approved for the treatment of Fontaine's stage III/IV regardless of its etiology, whereas iloprost is approved only for the treatment of thrombo-angiitis obliterans.