Beneficial effect of a new prostacyclin derivative on the walking capacity in patients with peripheral arterial insufficiency.
The efficacy, tolerance and safety of iloprost, a stable analogue of carbaprostacyclin, were evaluated in 7 patients with peripheral arterial insufficiency at stage II of Fontaine's classification. After washout, placebo was infused intravenously for seven days, then iloprost was given by a six-hour intravenous infusion of 1 ng/kg/min over the next seven days. At the end of each period, the initial (ICD) and the absolute (ACD) claudication distance were measured by treadmill. The ankle/arm systolic blood pressure ratio (WI) was also assessed, at rest and ten minutes after exercise. As compared with placebo, ICD increased from 98 +/- 60 to 137 +/- 91 meters (p less than 0.05) and ACD from 151 +/- 76 to 210 +/- 95 meters (p less than 0.05). Similarly, WI rose from 0.44 +/- 0.14 to 0.52 +/- 0.18 (p less than 0.05) at rest and from 0.40 +/- 0.13 to 0.48 +/- 0.20 (p less than 0.05) ten minutes after treadmill exercise. Owing to the spontaneous fluctuation in walking distance experienced by such patients, an increase in ACD greater than or equal to 50% was considered as clinically relevant. In 3 patients, who experienced such an improvement, iloprost continued to be infused at the same dosage as before, for an additional seven days. In the remaining 4 patients (nonresponders), the dose was increased to 2 ng/kg/min.(ABSTRACT TRUNCATED AT 250 WORDS)
Brevetti
G
G
Department of Medicine, 2nd Medical School, University of Naples, Italy.
Rossini
A
A
Perna
S
S
Policicchio
A
A
Attisano
T
T
Ciotola
M
M
Quattrin
S
S
Condorelli
M
M
Chiariello
M
M
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D011464:Epoprostenol / Q000627:therapeutic use*; D015444:Exercise; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D016285:Iloprost; D007262:Infusions, Intravenous; D007383:Intermittent Claudication / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*
D010975:Platelet Aggregation Inhibitors; D011464:Epoprostenol; D016285:Iloprost