Pentoxifylline therapy for chronic claudication: are patients dependent on therapy?
BACKGROUND
The purpose of this study was to evaluate the efficacy of long-term pentoxifylline therapy.


METHODS
Fifty consecutive patients on long-term pentoxifylline therapy entered a weaning program. The standard dose of 400 mg three times a day was reduced to 400 mg twice a day for 1 month, 400 mg daily for an additional month, and then withdrawn completely for 3 months. Subjective evaluation of each patient's symptoms and objective measurements (treadmill testing for initial claudication distance, maximum walking distance, and ankle/brachial indexes) were evaluated during treatment withdrawal.


RESULTS
Twenty-seven patients tolerated withdrawal of therapy without symptomatic deterioration. Seven of nine patients who did not tolerate weaning had deterioration of treadmill ICD/MWD parameters; there was a significant absolute decrease (p = 0.016) in MWD from 430 +/- 78 to 221 +/- 23 feet. Patients with an initial low MWD were less likely to tolerate weaning. Sixty percent of the patients with successful weaning had clinically asymptomatic deterioration of treadmill ICD/MWD parameters.


CONCLUSIONS
A substantial number of patients who have been on long-term successful pentoxifylline therapy for claudication can be weaned from the drug. Asymptomatic deterioration of treadmill test parameters is not an indication for resuming therapy.
Johnson
W C
WC
Department of Vascular Surgery, Boston Veterans Administration Medical Center Tufts University School of Medicine, Mass.
Watkins
M T
MT
Hamilton
J
J
Baldwin
D
D
Walker
N
N
D000368:Aged; D002908:Chronic Disease; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy*; D010431:Pentoxifylline / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D013375:Substance Withdrawal Syndrome; D016138:Walking
D010431:Pentoxifylline