Pharmacologic therapy for intermittent claudication.
Peripheral artery disease, defined as atherosclerosis in the lower extremities, affects nearly 8.5 million people in the United States. Due to the frequent asymptomatic manifestation of peripheral artery disease, diagnosis may be delayed and its true incidence underestimated. However, some patients may experience aching pain, numbness, weakness, or fatigue, a condition termed intermittent claudication. Peripheral atherosclerosis is associated with cardiovascular risk and physical impairment; therefore, treatment goals are aimed at decreasing cardiovascular risk, as well as improving quality of life. Little debate exists regarding the management of cardiovascular risk reduction, which consists of both antiplatelet therapy and risk factor modification. Despite recently published guidelines, the treatment of intermittent claudication is less well established and the management remains controversial and uncertain. Exercise remains the first-line therapy for intermittent claudication; however, pharmacologic treatment is often necessary. Although only two prescription drugs have been approved by the U.S. Food and Drug Administration for the treatment of intermittent claudication, several supplements and investigational agents have been evaluated. Therapeutic optimization should balance the anticipated improvements in quality of life with the potential safety risks.
Dobesh
Paul P
PP
College of Pharmacy, University of Nebraska Medical Center, 986045 Nebraska Medical Center, Omaha, NE 68198-6045, USA. pdobesh@unmc.edu
Stacy
Zachary A
ZA
Persson
Emily L
EL
D000077407:Cilostazol; D002986:Clinical Trials as Topic; D019587:Dietary Supplements; D015507:Drugs, Investigational / Q000627:therapeutic use*; D005081:Exercise Therapy; D017408:Guidelines as Topic; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy* / Q000628:therapy; D015201:Meta-Analysis as Topic; D009257:Nafronyl / Q000627:therapeutic use; D010431:Pentoxifylline / Q000627:therapeutic use; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D011759:Pyrrolidines / Q000627:therapeutic use; D012307:Risk Factors; D013777:Tetrazoles / Q000627:therapeutic use; D016896:Treatment Outcome
D015507:Drugs, Investigational; D011759:Pyrrolidines; D013777:Tetrazoles; D009257:Nafronyl; D000077407:Cilostazol; D010431:Pentoxifylline; C010651:buflomedil