caa a22 4500 475818369 CHVBK 20180406123815.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1007/s002280000114 doi (NATIONALLICENCE)springer-10.1007/s002280000114 Oral vasoactive medication in intermittent claudication: utile or futile? [Elektronische Daten] [T. L. De Backer, R. H. Vander Stichele, H. H. Warie, M. G. Bogaert] Objective: To evaluate the role of orally administered vasoactive medication in the management of intermittent claudication. Setting: We limited our study to the products on the market in Belgium: cinnarizine, cyclandelate, isoxsuprine, naftidrofuryl, pentoxifylline, xanthinol nicotinate and buflomedil. Data sources: We conducted a systematic literature search involving Medline, International Pharmaceutical Abstracts, the Cochrane Library, direct contact with marketing companies and key authors, snowballing and Science Citation Index search. We looked for randomised placebo-controlled trials (RCTs) in patients with Fontaine stage II, in which pain-free and/or maximal walking distance were measured using a standardised exercise test. For isoxsuprine and xanthinol nicotinate, no trials conforming to these criteria were found. Thirty-six trials on cinnarizine, cyclandelate, buflomedil, naftidrofuryl and pentoxifylline met our inclusion criteria. Study selection: After quality assessment, 26 trials were excluded, mainly because of short trial duration (less than 12 weeks), small sample size (less than 30 patients) and/or failure to report details on variability (standard deviation or confidence limits). For cinnarizine and cyclandelate, none of the three selected RCTs was included. Data extraction: For buflomedil, of six published RCTs, two were included after quality assessment, each showing a marginally positive effect of buflomedil versus placebo. For naftidrofuryl, nine RCTs were selected; six were included of which five showed a significant positive result. The likelihood of publication bias and the heterogeneity of the results within and between trials precluded a meta-analysis. For pentoxifylline, of the 18 selected RCTs, only two could be included, both with inconclusive results. Conclusion: A national consensus conference, based on this review, concluded that health resources should be allocated to prevention and rehabilitation of intermittent claudication rather than to reimbursement of these products with doubtful efficacy. Springer-Verlag Berlin Heidelberg, 2000 Key words Oral vasoactive medication nationallicence Intermittent claudication nationallicence De Backer T. L. Heymans Institute of Pharmacology, Ghent University Medical School, De Pintelaan 185, B-9000 Ghent, Belgium, BE aut Vander Stichele R. H. Heymans Institute of Pharmacology, Ghent University Medical School, De Pintelaan 185, B-9000 Ghent, Belgium, BE aut Warie H. H. Heymans Institute of Pharmacology, Ghent University Medical School, De Pintelaan 185, B-9000 Ghent, Belgium, BE aut Bogaert M. G. Heymans Institute of Pharmacology, Ghent University Medical School, De Pintelaan 185, B-9000 Ghent, Belgium, BE aut https://doi.org/10.1007/s002280000114 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280000114 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- De Backer T. L. Heymans Institute of Pharmacology, Ghent University Medical School, De Pintelaan 185, B-9000 Ghent, Belgium, BE aut NATIONALLICENCE 700 1- Vander Stichele R. H. Heymans Institute of Pharmacology, Ghent University Medical School, De Pintelaan 185, B-9000 Ghent, Belgium, BE aut NATIONALLICENCE 700 1- Warie H. H. Heymans Institute of Pharmacology, Ghent University Medical School, De Pintelaan 185, B-9000 Ghent, Belgium, BE aut NATIONALLICENCE 700 1- Bogaert M. G. Heymans Institute of Pharmacology, Ghent University Medical School, De Pintelaan 185, B-9000 Ghent, Belgium, BE aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer