Cilostazol: Treatment of Intermittent Claudication
Cilostazol: Treatment of Intermittent Claudication
复制标题
西洛他唑：间歇性跛行的治疗
DOI：
--
复制
发表时间：
2001
期刊：
影响因子：
--
通讯作者：
E. Mohler
中科院分区：
文献类型：
--
作者：
M. Reilly;E. Mohler
目的：综述用于治疗间歇性跛行的抗血小板和血管扩张剂西洛他唑的药理和临床应用。资料来源：通过MEDLINE综合文献检索(1980-2000-02)确定有关西洛他唑的主要文献。精选的会议摘要和制造商文献也被用作原始材料。检索术语包括西洛他唑、间歇性跛行、血小板抑制剂和再狭窄。资料选择：对在美国和亚洲进行的人类临床、药代动力学和随机对照试验进行综述。选择的体外、体外和动物研究在没有人类数据的情况下进行评估。资料综合：间歇性跛行是外周动脉疾病(PAD)最常见的临床表现。间歇性跛行是指由运动引起的肌肉群可重复出现的不适，经休息后缓解。西洛他唑是一种血小板和血管平滑肌细胞中环磷酸腺苷二酯酶的特异性抑制剂，在体内是一种有效的抗血小板药物和血管扩张剂，可减少血管增殖并具有降脂作用。最近的多中心、随机、安慰剂对照试验导致食品和药物管理局批准西洛他唑用于缓解稳定性PAD患者的间歇性跛行。在这些研究中，与安慰剂相比，西洛他唑的步行距离增加了一倍，生活质量得到了改善。一项试验发现，西洛他唑比己酮可可碱更有效，己酮可可碱是治疗跛行的唯一替代药物。尽管在临床实践中可能会出现常见的轻微不良反应(∼为50%)，包括头痛、腹泻和心悸，但西洛他唑并未与重大不良事件或死亡率增加有关。小规模的非盲法研究表明，西洛他唑在预防经皮冠状动脉介入治疗后血栓形成和再狭窄方面可能是有效的，尽管这些用途仍未标记。结论：西洛他唑独特的抗血小板、血管扩张和抗增殖作用使其成为治疗PAD患者的一种有吸引力的药物。临床试验表明，西洛他唑治疗可以显著改善步行距离，这表明它将成为改善间歇性跛行患者症状和生活质量的重要工具。
OBJECTIVE: To review the pharmacology and clinical utility of cilostazol, an antiplatelet and vasodilator agent approved for the management of intermittent claudication. DATA SOURCES: Primary literature on cilostazol was identified from a comprehensive MEDLINE literature search (1980–February 2000). Selected meeting abstracts and manufacturer literature were also used as source material. Indexing terms included cilostazol, intermittent claudication, platelet inhibitors, and restenosis. STUDY SELECTION: Human clinical, pharmacokinetic and randomized comparative trials performed in the US and Asia were reviewed. Selected in vitro, ex vivo, and animal studies were evaluated when human data were not available. DATA SYNTHESIS: Intermittent claudication, defined as reproducible discomfort of a muscle group induced by exercise and relieved by rest, is the most common clinical manifestation of peripheral arterial disease (PAD). Cilostazol, a specific inhibitor of cyclic adenosine monophosphate phosphodiesterase in platelets and vascular smooth-muscle cells, is a potent antiplatelet agent and vasodilator that reduces vascular proliferation and has lipid-lowering effects in vivo. Recent multicenter, randomized, placebo-controlled trials have led to approval of cilostazol by the Food and Drug Administration for relief of intermittent claudication in patients with stable PAD. Cilostazol doubled walking distances and improved quality of life compared with placebo in these studies. One trial found that cilostazol was more effective than pentoxifylline, the only alternative pharmacologic therapy for claudication. Although frequent (∼50%) minor adverse effects, including headache, diarrhea, and palpitations, may occur in clinical practice, cilostazol has not been associated with major adverse events or increased mortality. Small, nonblind studies suggest that cilostazol may prove useful in preventing thrombosis and restenosis following percutaneous coronary interventions, although these remain unlabeled uses. CONCLUSIONS: The unique combination of antiplatelet, vasodilatory, and antiproliferative effects of cilostazol appear to make it an attractive agent for use in patients with PAD. Clinical trials demonstrating a significant improvement in walking distances with cilostazol therapy suggest that it will be an important tool in improving symptoms and quality of life in patients with intermittent claudication.
DOI：
10.1172/jci118049
发表时间：
1995-07
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
K. Matoušovic;J. Grande;C. C. Chini-C.;E. Chini;T. Dousa
通讯作者：
K. Matoušovic;J. Grande;C. C. Chini-C.;E. Chini;T. Dousa