The efficacy of oral beraprost sodium, a prostaglandin I2 analogue, for treating intermittent claudication in patients with arteriosclerosis obliterans.
OBJECTIVE
This study aimed to evaluate the effect of oral beraprost sodium, a prostaglandin I2 analogue, on symptoms of intermittent claudication in patients with arteriosclerosis obliterans. The research design consisted of a before and after treatment study without comparison groups. The subjects comprised arteriosclerosis obliterans patients who experienced intermittent claudication. Furthermore, this study aimed to assess the mechanism of action of beraprost sodium via blood sampling and measurements of flow-mediated vasodilatation before and after treatment.


METHODS
The study was performed prospectively in 7 patients with arteriosclerosis obliterans. Beraprost sodium (40 microg) was orally administered to 7 patients at study entry, followed by administration of 120 microg/day for 12 weeks. Blood sampling and measurements of flow-mediated vasodilatation were performed before and after treatment at study entry, 4 weeks, and 12 weeks after treatment. Treadmill exercise tests were performed three times at study entry, 4 weeks, and 12 weeks after treatment. The ankle-brachial index (ABI) was measured at rest and after exercise.


RESULTS
Pain-free walking distances increased by 138% at 12 weeks after treatment. Maximum walking distances increased by 133%. The ABI was significantly increased at 4 weeks and 12 weeks after treatment at rest. Endothelin-1 levels tended to be decreased at 1 h after administration of 40 microg beraprost sodium. N(G),N(G)-dimethyl-L-arginine, nitrate ions, and flow-mediated vasodilatation.


CONCLUSIONS
Beraprost sodium tended to decrease endothelin-1 levels and improved symptoms of intermittent claudication in patients with arteriosclerosis obliterans.
Matsumoto
T
T
Department of Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. takum@surg2.med.kyushu-u.ac.jp
Iwasa
K
K
Kyuragi
R
R
Honma
K
K
Guntani
A
A
Ohmine
T
T
Itoh
H
H
Onohara
T
T
Maehara
Y
Y
D000284:Administration, Oral; D000368:Aged; D055109:Ankle Brachial Index; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D001162:Arteriosclerosis Obliterans / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D019332:Endothelin-1 / Q000097:blood; D011464:Epoprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage*; D016138:Walking
D015415:Biomarkers; D019332:Endothelin-1; D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; C048081:beraprost; C024917:symmetric dimethylarginine; D001120:Arginine; D011464:Epoprostenol