Established and evolving medical therapies for claudication in patients with peripheral arterial disease

Claudication resulting from peripheral arterial disease causes substantial impairment in the ability to carry out normal daily activities. The medical treatments for claudication that are currently available are exercise rehabilitation and one drug, cilostazol. Pentoxifylline, which improves red cell deformability, lowers fibrinogen levels and decreases platelet aggregation, has been used historically, but frequency of use has declined because of limited effectiveness. Exercise rehabilitation, while efficacious, has been underused in the past. This therapy is, however, currently the subject of several large research projects. These studies are investigating mechanisms by which exercise therapy could benefit people with claudication and are also directly comparing it with other therapies. Concurrently, several new drug therapies for claudication are in the process of being evaluated. These research efforts might increase the available armamentarium and thereby help to alleviate the impairments associated with this symptom. The aim of this article is to discuss the current medical treatments being developed for use in patients with claudication resulting from peripheral arterial disease.