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Prostanoids for critical limb ischaemia.

Antonio J Ruffolo1, Marina Romano, Agustín Ciapponi

  • 1c/o Cochrane Peripheral Vascular Diseases Group, Public Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, UK, EH8 9AG.

The Cochrane Database of Systematic Reviews
|January 22, 2010
PubMed
Summary
This summary is machine-generated.

Prostanoids may help with critical limb ischaemia (CLI) symptoms like pain and ulcers, and potentially reduce amputations. However, more high-quality research is needed to confirm their long-term effectiveness and safety.

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Area of Science:

  • Vascular Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Peripheral arterial occlusive disease (PAOD) is a significant contributor to cardiovascular morbidity and mortality.
  • Critical limb ischaemia (CLI) often necessitates amputation due to limited treatment options for patients unsuitable for intervention.

Purpose of the Study:

  • To evaluate the efficacy and safety of prostanoids in managing critical limb ischaemia (CLI).
  • To synthesize evidence from randomized controlled trials (RCTs) on prostanoid treatment for CLI.

Main Methods:

  • Comprehensive literature search of multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to October 2009.
  • Inclusion of 20 randomized controlled trials (RCTs) comparing prostanoids with placebo or other treatments for CLI.
  • Independent data extraction and quality assessment by two authors.

Main Results:

  • Prostanoids demonstrated efficacy in relieving rest pain (RR 1.32, 95% CI 1.10-1.57) and promoting ulcer healing (RR 1.54, 95% CI 1.22-1.96).
  • Iloprost showed a trend towards reducing major amputations (RR 0.69, 95% CI 0.52-0.93).
  • Common adverse events included headache, facial flushing, nausea, vomiting, and diarrhea.

Conclusions:

  • Prostanoids show potential benefits for CLI symptoms, including pain relief, ulcer healing, and possibly reducing amputations.
  • Current meta-analysis lacks conclusive evidence on the long-term effectiveness and safety of various prostanoids for CLI.
  • Further high-quality, randomized, double-blinded trials are essential to establish definitive conclusions.