1. [Severe intermittent claudication: PGE1 treatment. A 40-week registry, efficacy and costs].
- Author
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Luzzi R, Belcaro G, Ippolito E, Dugall M, Cesarone MR, Scoccianti M, Errichi BM, Pellegrini L, Ciammaichella G, Ledda A, Ricci A, Cornelli U, Feragalli B, Hosoi M, Corsi M, Simeone E, and Agus GB
- Subjects
- Aged, Analysis of Variance, Cost-Benefit Analysis, Exercise Test economics, Female, Follow-Up Studies, Humans, Intermittent Claudication diagnosis, Intermittent Claudication economics, Intermittent Claudication mortality, Italy epidemiology, Male, Middle Aged, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Alprostadil administration & dosage, Intermittent Claudication drug therapy, Vasodilator Agents administration & dosage
- Abstract
Aim: Intermittent claudication (IC) in peripheral vascular disease is characterized by lower limb pain appearing on effort. Treatment with PGE1 has been successfully used to manage IC patients. This registry has evaluated safety and costs of PGE1 in the management of IC., Methods: In this study a long-term treatment protocol (LTP), a short-term protocol (STP) and an outpatient (OP), "on-demand" treatment have been compared. A treadmill effort test has been used to evaluate walking distance. The follow up for these three protocols was 40 weeks. PGE1 treatment was associated to a risk reduction plan and to an exercise program., Results: The final analysis has included 252 LTP patients, 223 STP patients and 284 OP patients (total 659 valid cases). A group of 171 comparable patients not treated with PGE1 was used for a parallel comparison. Cardiovascular mortality and morbidity has been evaluated in 731 PGE1 patients completing 24 months of follow up. All protocols have been well tolerated. No side effects were observed. The lower cost has been observed for OP patients. In the long term, mortality and morbidity were lower in patients treated with PGE1 in comparison with patients not treated with PGE1., Conclusion: Considering costs and results (increase in walking distance) and improvement in Karnofsky scale the STP plan appears to be better than LTP for IC patients. The OP, "on-demand" treatment offers further improvements. This last treatment plan is simpler; the plan allows better timing for exercise. The treatment can be used even in non-specialized centers.
- Published
- 2012