title: [Severe intermittent claudication: PGE1 treatment. A 40-week registry, efficacy and costs].
abstract: OBJECTIVE
  Intermittent claudication (IC) in peripheral vascular disease is characterized by lower limb pain appearing on effort. Treatment with PGE1 has been successfully used to manage IC patients. This registry has evaluated safety and costs of PGE1 in the management of IC.
  
  
  METHODS
  In this study a long-term treatment protocol (LTP), a short-term protocol (STP) and an outpatient (OP), "on-demand" treatment have been compared. A treadmill effort test has been used to evaluate walking distance. The follow up for these three protocols was 40 weeks. PGE1 treatment was associated to a risk reduction plan and to an exercise program.
  
  
  RESULTS
  The final analysis has included 252 LTP patients, 223 STP patients and 284 OP patients (total 659 valid cases). A group of 171 comparable patients not treated with PGE1 was used for a parallel comparison. Cardiovascular mortality and morbidity has been evaluated in 731 PGE1 patients completing 24 months of follow up. All protocols have been well tolerated. No side effects were observed. The lower cost has been observed for OP patients. In the long term, mortality and morbidity were lower in patients treated with PGE1 in comparison with patients not treated with PGE1.
  
  
  CONCLUSIONS
  Considering costs and results (increase in walking distance) and improvement in Karnofsky scale the STP plan appears to be better than LTP for IC patients. The OP, "on-demand" treatment offers further improvements. This last treatment plan is simpler; the plan allows better timing for exercise. The treatment can be used even in non-specialized centers.
authors.affiliation: Department of Biomedical Sciences, Chieti-Pescara University, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Luzzi
authors.forename: G
authors.initials: G
authors.lastname: Belcaro
authors.forename: E
authors.initials: E
authors.lastname: Ippolito
authors.forename: M
authors.initials: M
authors.lastname: Dugall
authors.forename: M R
authors.initials: MR
authors.lastname: Cesarone
authors.forename: M
authors.initials: M
authors.lastname: Scoccianti
authors.forename: B M
authors.initials: BM
authors.lastname: Errichi
authors.forename: L
authors.initials: L
authors.lastname: Pellegrini
authors.forename: G
authors.initials: G
authors.lastname: Ciammaichella
authors.forename: A
authors.initials: A
authors.lastname: Ledda
authors.forename: A
authors.initials: A
authors.lastname: Ricci
authors.forename: U
authors.initials: U
authors.lastname: Cornelli
authors.forename: B
authors.initials: B
authors.lastname: Feragalli
authors.forename: M
authors.initials: M
authors.lastname: Hosoi
authors.forename: M
authors.initials: M
authors.lastname: Corsi
authors.forename: E
authors.initials: E
authors.lastname: Simeone
authors.forename: G B
authors.initials: GB
authors.lastname: Agus
mesh_terms: D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage*; D000704:Analysis of Variance; D003362:Cost-Benefit Analysis; D005080:Exercise Test / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D014665:Vasodilator Agents; D000527:Alprostadil