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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
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Prostanoids for intermittent claudication.

Lindsay Robertson1, Alina Andras

  • 1Centre for Population Health Sciences, The Medical School, The University of Edinburgh, Teviot Place, Edinburgh, UK, EH8 9AG.

The Cochrane Database of Systematic Reviews
|May 2, 2013
PubMed
Summary

The efficacy of prostanoids for intermittent claudication (PAD II) remains uncertain due to insufficient high-quality evidence. More robust randomized trials are needed to determine clinical benefits and establish prostanoids as a treatment for peripheral arterial disease.

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Area of Science:

  • Vascular Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Peripheral arterial disease (PAD) is a prevalent condition affecting numerous individuals.
  • While prostanoids are effective for advanced PAD stages (III-IV), their role in intermittent claudication (PAD II) is unclear.
  • This review updates previous findings on prostanoid efficacy in PAD II.

Purpose of the Study:

  • To evaluate the effects of prostanoids in patients experiencing intermittent claudication (Fontaine stage II).
  • To assess prostanoids as an alternative or additive treatment for PAD II.

Main Methods:

  • Systematic review and meta-analysis of randomized clinical trials.
  • Included trials compared prostanoids against placebo or alternative treatments.
  • Primary outcomes were pain-free walking distance (PFWD) and maximum walking distance (MWD).

Main Results:

  • Eighteen trials with 2773 patients were analyzed; data quality was variable and often insufficient for statistical significance.
  • Prostaglandin E1 (PGE1) showed potential increases in walking distance in some trials, but comparisons were limited.
  • Prostacyclin (PGI2) studies yielded mixed results, with some showing dose-dependent improvements but also higher withdrawal rates due to adverse events.

Conclusions:

  • Current evidence quality is insufficient to confirm clinically meaningful benefits of prostanoids for intermittent claudication.
  • Limitations include trial heterogeneity and inadequate reporting of outcomes.
  • Further high-quality, adequately powered randomized controlled trials are necessary to definitively answer the efficacy question.