title: Sarpogrelate hydrochloride, a selective 5-HT(2A) receptor antagonist, improves skin perfusion pressure of the lower extremities in hemodialysis patients with peripheral arterial disease.
abstract: BACKGROUND
  Peripheral arterial disease (PAD) frequently occurs in patients on hemodialysis (HD); however, little is known about the effectiveness of drugs. We compare the effects of sarpogrelate and cilostazol in HD patients with PAD.
  
  
  METHODS
  We conducted a prospective, randomized, open-label, and multicenter trial for 24 weeks in HD patients with PAD. Thirty-five patients were divided into two groups: sarpogrelate (n = 17) and cilostazol (n = 18). We analyzed changes in skin perfusion pressure (SPP), levels of oxidative stress biomarkers, and adverse events.
  
  
  RESULTS
  At 24 weeks, SPP was increased in both groups (sarpogrelate, 43 ± 17 to 55 ± 15 mmHg; cilostazol, 49 ± 21 to 66 ± 29 mmHg; p < 0.05), and no difference was observed between the groups. Plasma pentosidine levels decreased in both groups (sarpogrelate, 0.65 ± 0.24 to 0.48 ± 0.12 mg/mL; cilostazol, 0.58 ± 0.22 to 0.47 ± 0.17 mg/mL; p < 0.05), and there were no differences between the groups. Serum malondialdehyde-modified low-density lipoprotein (MDA-LDL) levels significantly increased only in cilostazol group (p < 0.05). There were no clinically significant safety concerns linked to the both drugs. Although blood pressure did not differ in both groups, heart rate increased only in cilostazol group from 77 ± 13 to 83 ± 16 beats per minute (p < 0.05).
  
  
  CONCLUSIONS
  Sarpogrelate improves SPP in HD patients with PAD without increasing heart rate and serum MDA-LDL levels. We demonstrated that sarpogrelate is an effective and safe drug for the treatment of HD patients with PAD.
authors.affiliation: Department of Nephrology, Immunology and Vascular Medicine, Shonan Kamakura General Hospital, Kamakura, Japan. shidaka@shonankamakura.or.jp
authors.forename: Sumi
authors.initials: S
authors.lastname: Hidaka
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Masao
authors.initials: M
authors.lastname: Iwagami
authors.forename: Rei
authors.initials: R
authors.lastname: Isshiki
authors.forename: Daimu
authors.initials: D
authors.lastname: Tsutsumi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mochida
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Ishioka
authors.forename: Machiko
authors.initials: M
authors.lastname: Oka
authors.forename: Kyoko
authors.initials: K
authors.lastname: Maesato
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Moriya
authors.forename: Takayasu
authors.initials: T
authors.lastname: Ohtake
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000628:therapy; D035002:Lower Extremity / Q000098:blood supply* / Q000503:physiopathology; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects; D010101:Oxygen Consumption / Q000502:physiology*; D058729:Peripheral Arterial Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D006435:Renal Dialysis; D058830:Serotonin 5-HT2 Receptor Antagonists / Q000627:therapeutic use; D012867:Skin / Q000378:metabolism* / Q000503:physiopathology; D013386:Succinates / Q000627:therapeutic use*
chemical_list: D058830:Serotonin 5-HT2 Receptor Antagonists; D013386:Succinates; C064294:sarpogrelate