A comparison of cilostazol and pentoxifylline for treating intermittent claudication

David L Dawson, Bruce S. Cutler, William R. Hiatt, Robert W. Hobson, John D. Martin, Enoch B. Bortey, William P. Forbes, D. Eugene Strandness

Research output: Contribution to journalArticle

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Abstract

PURPOSE: We performed a randomized, double-blind, placebo-controlled, multicenter trial to evaluate the relative efficacy and safety of cilostazol and pentoxifylline. PATIENTS AND METHODS: We enrolled patients with moderate-to-severe claudication from 54 outpatient vascular clinics, including sites at Air Force, Veterans Affairs, tertiary care, and university medical centers in the United States. Of 922 consenting patients, 698 met the inclusion criteria and were randomly assigned to blinded treatment with either cilostazol (100 mg orally twice a day), pentoxifylline (400 mg orally 3 times a day), or placebo. We measured maximal walking distance with constant-speed, variable-grade treadmill testing at baseline and at 4, 8, 12, 16, 20, and 24 weeks. RESULTS: Mean maximal walking distance of cilostazol-treated patients (n = 227) was significantly greater at every postbaseline visit compared with patients who received pentoxifylline (n = 232) or placebo (n = 239). After 24 weeks of treatment, mean maximal walking distance increased by a mean of 107 m (a mean percent increase of 54% from baseline) in the cilostazol group, significantly more than the 64-m improvement (a 30% mean percent increase) with pentoxifylline (P < 0.001). The improvement with pentoxifylline was similar (P = 0.82) to that in the placebo group (65 m, a 34% mean percent increase). Deaths and serious adverse event rates were similar in each group. Side effects (including headache, palpitations, and diarrhea) were more common in the cilostazol-treated patients, but withdrawal rates were similar in the cilostazol (16%) and pentoxifylline (19%) groups. CONCLUSION: Cilostazol was significantly better than pentoxifylline or placebo for increasing walking distances in patients with intermittent claudication, but was associated with a greater frequency of minor side effects. Pentoxifylline and placebo had similar effects. (C) 2000 by Excerpta Medica, Inc.

Original languageEnglish (US)
Pages (from-to)523-530
Number of pages8
JournalAmerican Journal of Medicine
Volume109
Issue number7
DOIs
StatePublished - 2000
Externally publishedYes

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Pentoxifylline
Intermittent Claudication
Placebos
Walking
cilostazol
Veterans
Tertiary Healthcare
Ambulatory Care Facilities
Multicenter Studies
Blood Vessels
Headache
Diarrhea
Air
Safety
Therapeutics

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Dawson, D. L., Cutler, B. S., Hiatt, W. R., Hobson, R. W., Martin, J. D., Bortey, E. B., ... Strandness, D. E. (2000). A comparison of cilostazol and pentoxifylline for treating intermittent claudication. American Journal of Medicine, 109(7), 523-530. https://doi.org/10.1016/S0002-9343(00)00569-6

A comparison of cilostazol and pentoxifylline for treating intermittent claudication. / Dawson, David L; Cutler, Bruce S.; Hiatt, William R.; Hobson, Robert W.; Martin, John D.; Bortey, Enoch B.; Forbes, William P.; Strandness, D. Eugene.

In: American Journal of Medicine, Vol. 109, No. 7, 2000, p. 523-530.

Research output: Contribution to journalArticle

Dawson, DL, Cutler, BS, Hiatt, WR, Hobson, RW, Martin, JD, Bortey, EB, Forbes, WP & Strandness, DE 2000, 'A comparison of cilostazol and pentoxifylline for treating intermittent claudication', American Journal of Medicine, vol. 109, no. 7, pp. 523-530. https://doi.org/10.1016/S0002-9343(00)00569-6
Dawson, David L ; Cutler, Bruce S. ; Hiatt, William R. ; Hobson, Robert W. ; Martin, John D. ; Bortey, Enoch B. ; Forbes, William P. ; Strandness, D. Eugene. / A comparison of cilostazol and pentoxifylline for treating intermittent claudication. In: American Journal of Medicine. 2000 ; Vol. 109, No. 7. pp. 523-530.
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abstract = "PURPOSE: We performed a randomized, double-blind, placebo-controlled, multicenter trial to evaluate the relative efficacy and safety of cilostazol and pentoxifylline. PATIENTS AND METHODS: We enrolled patients with moderate-to-severe claudication from 54 outpatient vascular clinics, including sites at Air Force, Veterans Affairs, tertiary care, and university medical centers in the United States. Of 922 consenting patients, 698 met the inclusion criteria and were randomly assigned to blinded treatment with either cilostazol (100 mg orally twice a day), pentoxifylline (400 mg orally 3 times a day), or placebo. We measured maximal walking distance with constant-speed, variable-grade treadmill testing at baseline and at 4, 8, 12, 16, 20, and 24 weeks. RESULTS: Mean maximal walking distance of cilostazol-treated patients (n = 227) was significantly greater at every postbaseline visit compared with patients who received pentoxifylline (n = 232) or placebo (n = 239). After 24 weeks of treatment, mean maximal walking distance increased by a mean of 107 m (a mean percent increase of 54{\%} from baseline) in the cilostazol group, significantly more than the 64-m improvement (a 30{\%} mean percent increase) with pentoxifylline (P < 0.001). The improvement with pentoxifylline was similar (P = 0.82) to that in the placebo group (65 m, a 34{\%} mean percent increase). Deaths and serious adverse event rates were similar in each group. Side effects (including headache, palpitations, and diarrhea) were more common in the cilostazol-treated patients, but withdrawal rates were similar in the cilostazol (16{\%}) and pentoxifylline (19{\%}) groups. CONCLUSION: Cilostazol was significantly better than pentoxifylline or placebo for increasing walking distances in patients with intermittent claudication, but was associated with a greater frequency of minor side effects. Pentoxifylline and placebo had similar effects. (C) 2000 by Excerpta Medica, Inc.",
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T1 - A comparison of cilostazol and pentoxifylline for treating intermittent claudication

AU - Dawson, David L

AU - Cutler, Bruce S.

AU - Hiatt, William R.

AU - Hobson, Robert W.

AU - Martin, John D.

AU - Bortey, Enoch B.

AU - Forbes, William P.

AU - Strandness, D. Eugene

PY - 2000

Y1 - 2000

N2 - PURPOSE: We performed a randomized, double-blind, placebo-controlled, multicenter trial to evaluate the relative efficacy and safety of cilostazol and pentoxifylline. PATIENTS AND METHODS: We enrolled patients with moderate-to-severe claudication from 54 outpatient vascular clinics, including sites at Air Force, Veterans Affairs, tertiary care, and university medical centers in the United States. Of 922 consenting patients, 698 met the inclusion criteria and were randomly assigned to blinded treatment with either cilostazol (100 mg orally twice a day), pentoxifylline (400 mg orally 3 times a day), or placebo. We measured maximal walking distance with constant-speed, variable-grade treadmill testing at baseline and at 4, 8, 12, 16, 20, and 24 weeks. RESULTS: Mean maximal walking distance of cilostazol-treated patients (n = 227) was significantly greater at every postbaseline visit compared with patients who received pentoxifylline (n = 232) or placebo (n = 239). After 24 weeks of treatment, mean maximal walking distance increased by a mean of 107 m (a mean percent increase of 54% from baseline) in the cilostazol group, significantly more than the 64-m improvement (a 30% mean percent increase) with pentoxifylline (P < 0.001). The improvement with pentoxifylline was similar (P = 0.82) to that in the placebo group (65 m, a 34% mean percent increase). Deaths and serious adverse event rates were similar in each group. Side effects (including headache, palpitations, and diarrhea) were more common in the cilostazol-treated patients, but withdrawal rates were similar in the cilostazol (16%) and pentoxifylline (19%) groups. CONCLUSION: Cilostazol was significantly better than pentoxifylline or placebo for increasing walking distances in patients with intermittent claudication, but was associated with a greater frequency of minor side effects. Pentoxifylline and placebo had similar effects. (C) 2000 by Excerpta Medica, Inc.

AB - PURPOSE: We performed a randomized, double-blind, placebo-controlled, multicenter trial to evaluate the relative efficacy and safety of cilostazol and pentoxifylline. PATIENTS AND METHODS: We enrolled patients with moderate-to-severe claudication from 54 outpatient vascular clinics, including sites at Air Force, Veterans Affairs, tertiary care, and university medical centers in the United States. Of 922 consenting patients, 698 met the inclusion criteria and were randomly assigned to blinded treatment with either cilostazol (100 mg orally twice a day), pentoxifylline (400 mg orally 3 times a day), or placebo. We measured maximal walking distance with constant-speed, variable-grade treadmill testing at baseline and at 4, 8, 12, 16, 20, and 24 weeks. RESULTS: Mean maximal walking distance of cilostazol-treated patients (n = 227) was significantly greater at every postbaseline visit compared with patients who received pentoxifylline (n = 232) or placebo (n = 239). After 24 weeks of treatment, mean maximal walking distance increased by a mean of 107 m (a mean percent increase of 54% from baseline) in the cilostazol group, significantly more than the 64-m improvement (a 30% mean percent increase) with pentoxifylline (P < 0.001). The improvement with pentoxifylline was similar (P = 0.82) to that in the placebo group (65 m, a 34% mean percent increase). Deaths and serious adverse event rates were similar in each group. Side effects (including headache, palpitations, and diarrhea) were more common in the cilostazol-treated patients, but withdrawal rates were similar in the cilostazol (16%) and pentoxifylline (19%) groups. CONCLUSION: Cilostazol was significantly better than pentoxifylline or placebo for increasing walking distances in patients with intermittent claudication, but was associated with a greater frequency of minor side effects. Pentoxifylline and placebo had similar effects. (C) 2000 by Excerpta Medica, Inc.

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