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Prostanoids for intermittent claudication

Intermittent claudication (IC) is a symptom of lower limb ischaemia that results from peripheral arterial disease (PAD). It is evident as muscle pain (ache, cramp, numbness or sense of fatigue) in the leg muscles that occurs during exercise and is relieved by a short period of rest. Prostaglandin E1 (PGE1) and prostacyclin (PGI2), also known as prostanoids, are vasoactive drugs used in PAD to reduce arterial insufficiency. The aim of this review was to evaluate the effects of prostanoids in patients with IC. We identified 18 randomised studies with a total of 2773 participants, of which four studies compared the effects of PGE1 versus placebo. Overall, there was insufficient high quality evidence to suggest that PGE1 improves walking distances in people with IC. There was also a lack of evidence to determine if PGE1 was more effective than laevadosin, naftidrofuryl or L‐arginine. Evidence on the efficacy of prostacyclin was inconclusive. Results suggest that, compared with PGE1, prostacyclin may be associated with an increased occurrence of side effects including headache, diarrhoea and facial flushing.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Testosterone and oestrogen steroid sex hormones for lower limb atherosclerosis

Atherosclerosis of the arteries of the legs can become symptomatic as people age. People affected may experience discomfort and cramping pain in the legs that is triggered by exercise and relieved with rest, termed intermittent claudication. Some people with claudication go on to require reconstructive surgery and even amputation of a leg. Risk factors for peripheral arterial disease include cigarette smoking, high blood pressure, high cholesterol, low levels of high density lipoprotein (HDL) cholesterol and blood flow problems. The steroid sex hormones oestrogens and testosterone affect a number of these risk factors, particularly cholesterol and blood clotting, and may be helpful in peripheral vascular disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

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