Adjunctive pharmacotherapies for intermittent claudication-NICE guidance

摘要

There are a number of adjunctive pharmacother-apies available for individuals with peripheral arte-rial disease and intermittent claudication, in whom appropriate risk factor modification and anti-platelet treatment have been initiated. These include cilostazol, naftidrofuryl oxalate, pentox-ifylline and inositol nicotinate, which have vaso-dilatation among their mechanisms of action and have been the subject of recent technology appraisal guidance offered by the National Institute for Health and Clinical Excellence (NICE).~1 The guidance offered was based upon systematic review, meta-analysis and cost-effectiveness analysis and is summarised in box 1. The systematic review identified 26 randomised controlled trials, 14 of which examined cilostazol, 5 examined naftidrofuryl, 9 examined pentoxifyl-line and 3 examined inositol nicotinate (3 trials were three-way comparisons of cilostazol, pentox-ifylline and placebo).