The efficacy of Oral Beraprost Sodium, a prostaglandin I_2 analogue, for treating intermittent claudication in patients with arteriosclerosis obliterans

摘要

Aim. This study aimed to evaluate the effect of oral beraprost sodium, a prostaglandin I_2 analogue, on symptoms of intermittent claudication in patients with arteriosclerosis obliterans. The research design consisted of a before and after treatment study without comparison groups. The subjects comprised arteriosclerosis obliterans patients who experienced intermittent claudication. Furthermore, this study aimed to assess the mechanism of action of beraprost sodium via blood sampling and measurements of flow-mediated vasodilatation before and after treatment. Methods. The study was performed prospectively in 7 patients with arteriosclerosis obliterans. Beraprost sodium (40 mug) was orally administered to 7 patients at study entry, followed by administration of 120 [ig/day for 12 weeks. Blood sampling and measurements of flow-mediated vasodilatation were performed before and after treatment at study entry, 4 weeks, and 12 weeks after treatment. Treadmill exercise tests were performed three times at study entry, 4 weeks, and 12 weeks after treatment. The ankle-brachial index (ABI) was measured at rest and after exercise. Results. Pain-free walking distances increased by 138% at 12 weeks after treatment. Maximum walking distances increased by 133%. The ABI was significantly increased at 4 weeks and 12 weeks after treatment at rest. Endothelin-1 levels tended to be decreased at 1 h after administration of 40 ug beraprost sodium. N~G,N~G-dimethyl-L-arginine, nitrate ions, and flow-mediated vasodilatation were not significantly changed after treatment.Conclusion. Beraprost sodium tended to decrease endothe-lin-1 levels and improved symptoms of intermittent claudication in patients with arteriosclerosis obliterans.