title: Cilostazol prevents foot ulcers in diabetic patients with peripheral vascular disease.
abstract: Diabetic patients are at high risk of foot ulcerations that may lead to limb amputations with important socio-economic impact. Peripheral vascular disease may be frequently associated in diabetes mellitus type II with its main symptom, intermittent claudication. Many studies reported the known efficacy of cilostazol in treating vascular claudication. Metalloproteinase-9 (MMP-9) seems to be a biochemical marker implicated in chronic wounds and in particular in diabetic foot ulcers. Cilostazol appears to have a lowering effect on MMP-9 levels and this may suggest a beneficial effect in order to prevent or retard the onset of foot ulcer in diabetic patients. In our study, two groups of diabetic patients with peripheral vascular disease were divided into two groups according to the presence of claudication in order to receive cilostazol. Group A (31 patients without claudication) were not eligible to receive cilostazol whereas Group B (47 patients with claudication) received cilostazol administration for 24 weeks (100 mg orally twice daily). Median follow up was of 16 months. During the follow up, 4·25% of patients of Group B and 35·48% of patients of Group A (P < 0·01) showed onset of foot ulceration. Although further randomised and controlled studies are required cilostazol seems to show beneficial effects for primary prevention of diabetic foot ulcers.
authors.affiliation: Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Catanzaro, Italy.|Interuniversity Center of Phlebolymphology, International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Gracia of Catanzaro, Catanzaro, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: de Franciscis
authors.affiliation: Department of Health Science, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Gallelli
authors.affiliation: Unit of Surgery, Soverato Hospital, Catanzaro, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Battaglia
authors.affiliation: Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Molinari
authors.affiliation: Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Montemurro
authors.affiliation: Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors.forename: Domenico M
authors.initials: DM
authors.lastname: Stillitano
authors.affiliation: Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Buffone
authors.affiliation: Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Catanzaro, Italy.|Interuniversity Center of Phlebolymphology, International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Gracia of Catanzaro, Catanzaro, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Serra
mesh_terms: D000368:Aged; D000077407:Cilostazol; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000201:enzymology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007383:Intermittent Claudication / Q000150:complications* / Q000209:etiology; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D012189:Retrospective Studies; D013777:Tetrazoles / Q000008:administration & dosage*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D013777:Tetrazoles; D014665:Vasodilator Agents; D020780:Matrix Metalloproteinase 9; D000077407:Cilostazol
keywords: Cilostazol; Diabetic foot; Intermittent claudication; Metalloproteinase-9; Peripheral vascular disease