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Lack of effect of cyclandelate in peripheral arterial disease
Insights
Cyclandelate, used for peripheral arterial disease, showed no significant benefit over placebo in a double-blind trial. This study suggests cyclandelate has little objective value for intermittent claudication.
Area of Science:
- Vascular Medicine
- Pharmacology
Background:
- Peripheral arterial disease (PAD) management often includes vasodilators.
- The efficacy of cyclandelate in treating PAD, specifically intermittent claudication, lacks robust objective evidence.
Purpose of the Study:
- To objectively evaluate the efficacy of cyclandelate in patients with intermittent claudication.
- To compare cyclandelate's effects against a placebo using comprehensive hemodynamic measurements.
Main Methods:
- A double-blind, crossover trial involving 12 patients with intermittent claudication.
- Patients received cyclandelate (400 mg qid) and placebo for two months each.
- Peripheral hemodynamic parameters and treadmill claudication testing were assessed.
Main Results:
- No significant differences were observed between cyclandelate and placebo in subjective symptoms or objective measurements.
- Specific measurements included calf blood flow, vascular resistance, venous capacitance, finger/toe blood flow, and hyperemia reactions.
Conclusions:
- Cyclandelate at 400 mg qid for 4 weeks demonstrated little objective value in treating intermittent claudication in this patient cohort.
- Further research may be needed, but current evidence suggests limited efficacy for cyclandelate in PAD.
Abstract:
While cyclandelate is widely used in the therapy of peripheral arterial disease, objective evidence of its efficacy remains controversial. For this reason, 12 patients with intermittent claudication (average age of 66.8 years) received both cyclandelate 400 mg qid and placebo in a double-blind crossover trial lasting two months. During the cyclandelate and placebo periods, the following peripheral hemodynamic measurements were obtained using a plethysmograph and treadmill claudication testing: mean calf blood flow, vascular resistance and venous capacitance; finger and toe blood flow, pulsation amplitude and temperature before and after vasodilating maneuvers; arm and leg arterial pulsation amplitudes, one and ten minute calf reactive hyperemia reaction; 30 pound/30 second calf active hyperemia reactions and times of onset of claudication as measured on a treadmill. No major significant difference could be demonstrated between placebo and cyclandelate on any subjective symptom or any objective measurement. It is concluded that cyclandelate 400 mg qid for 4 weeks was of little objective value in treating this group of 12 patients with peripheral arterial disease and suffering from intermittent claudication.