Pharmacological treatment of patients with chronic critical limb ischemia: L-propionyl-carnitine enhances the short-term effects of PGE-1.
OBJECTIVE
To evaluate the therapeutic effects of L-propionyl-carnitine (LPC) in patients with critical limb ischemia (CLI), as defined by the TASC guidelines.


METHODS
The study, double-blinded, randomised, assessed intravenous infusion of LPC 1.2 g/day in combination with PGE-1, 60 mg/day (LPC group: 37 patients), or PGE-1 only (control group: 38 patients) in a total of 75 patients suffering from CLI. Treatment duration was 20 days. We evaluated rest pain, maximum walking distance (MWD) and skin ulcer size.


RESULTS
In both groups we observed a significant reduction in pain score and ulcer size and an increase in MWD. In the patients treated with the combination, the improvement was greater: median value for pain score decreased from 2.75 to 0.85 in the LPC group and from 2.51 to 1.71 in the control group; MWD increased from 55 M to 130 M in the LPC group, and from 55 M to 102 M in the control group; median decrease of ulcer size was significantly greater in patients treated with LPC + PGE1.


CONCLUSIONS
Our study shows that LPC, whose effectiveness on claudication is already known, has favourable effects in patients with CLI, since it reinforces the effects produced by PGE-1.
Milio
Glauco
G
Department of Internal Medicine Cardiovascular and Nephro-Urological Diseases, University of Palermo, Via M. Rutelli, 9-90143, Palermo, Italy. milio@unipa.it
Novo
Giuseppina
G
Genova
Caterina
C
Luigi Almasio
Piero
P
Novo
Salvatore
S
Pinto
Antonio
A
D000368:Aged; D000527:Alprostadil / Q000494:pharmacology / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000494:pharmacology / Q000627:therapeutic use; D002331:Carnitine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D002908:Chronic Disease; D004311:Double-Blind Method; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007511:Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D007866:Leg / Q000098:blood supply / Q000473:pathology; D007871:Leg Ulcer / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016138:Walking
D002316:Cardiotonic Agents; D014665:Vasodilator Agents; C003223:propionylcarnitine; D000527:Alprostadil; D002331:Carnitine