Multicriteria decision analysis for determining drug therapy for intermittent claudication

Area of Science:

• Vascular Medicine
• Pharmacoeconomics
• Clinical Decision Analysis

Background:

• Intermittent claudication treatment often lacks a clear scientific basis for drug selection.
• Existing drug therapies for intermittent claudication show variability in practice.

Purpose of the Study:

• To develop a quantitative, criteria-based decision analysis for evaluating drug treatment options for intermittent claudication.
• To objectively compare pentoxifylline, buflomedil, naftidrofuryl, and ticlopidine.

Main Methods:

• A decision analysis framework was employed, evaluating drugs based on therapeutic efficacy, safety, patient acceptance, and cost.
• Expert panels assigned utility values to criteria, and probability values assessed drug performance against each criterion.
• Drug scores were calculated by multiplying utility and probability values, then summing for a total score.

Main Results:

• Pentoxifylline achieved the highest overall score (69/100), indicating superior performance across all evaluated criteria.
• The drug ranking was: pentoxifylline, buflomedil, ticlopidine, and naftidrofuryl.
• Sensitivity analysis confirmed the stability of this drug ranking despite data modifications.

Conclusions:

• Pentoxifylline demonstrates the most favorable profile for treating intermittent claudication based on a comprehensive quantitative evaluation.
• This decision analysis provides a robust framework for evidence-based drug selection in managing intermittent claudication.
• The findings support prioritizing pentoxifylline in clinical practice for intermittent claudication management.