title: [Effectiveness of prostanoids in patients with critical leg ischemia].
abstract: Prostanoids (alprostadil and iloprost) are used for the treatment of patients with critical limb ischemia in whom revascularization procedure is inadequate or proved to be unsuccessful. According to a Cochrane analysis (CD006544) prostanoids differ in their effects on rest-pain relief and ulcer healing.
  
  
  OBJECTIVE
  To study the efficacy and safety of prostanoids for critical limb ischemia.
  
  
  METHODS
  Systematic literature search and meta-analysis (mixed treatment comparison) was performed.
  
  
  RESULTS
  Seven randomized controlled trials including 964 patients were analyzed. Compared to placebo, both alprostadil (OR: 3.2 95% CI: 1.7-5.5 and OR: 1.8 95% CI: 0.6-4.3) and iloprost (OR: 2.7 95% CI: 1.7-4.2 and OR: 2.5 95% CI: 1.0-5.4) were more efficacious with regard to rest-pain relief and ulcer healing and the difference between the two prostanoids was not significant (OR: 1.2 95% CI: 0.7-1.9 and OR: 0.74 95% CI: 0.3-1.5). Adverse events occurred significantly more often with both drugs compared to placebo, however, they were less frequent with alprostadil than with iloprost (OR 0.2 95% CI: 0.1-0.3).
  
  
  CONCLUSIONS
  Prostanoids have favorable effect on rest-pain relief and ulcer healing in critical limb ischemia, without statistically significant difference between the two available drugs. The Cochrane study (CD006544) reported mistaken results due to defaults in the analysis.
authors: Budapesti Corvinus Egyetem Egészség-gazdaságtani és Egészségügyi Technológiaelemzési Kutatóközpont Budapest Fővám tér 8. 1093. valentin.brodszky@uni-corvinus.hu
authors: Valentin
authors: V
authors: Brodszky
authors: Katalin
authors: K
authors: Farkas
authors: Zoltán
authors: Z
authors: Járai
authors: Anna
authors: A
authors: Landi
authors: Zsolt
authors: Z
authors: Pécsvárady
authors: Petra
authors: P
authors: Baji
authors: Orsolya
authors: O
authors: Balogh
authors: László
authors: L
authors: Gulácsi
authors: Márta
authors: M
authors: Péntek
mesh_terms: D000527:Alprostadil / Q000627:therapeutic use*; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use*; D007511:Ischemia / Q000188:drug therapy*; D007866:Leg / Q000098:blood supply*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012146:Rest; D012883:Skin Ulcer / Q000209:etiology / Q000517:prevention & control; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; D000527:Alprostadil; D016285:Iloprost