PGE1 and other prostaglandins in the treatment of intermittent claudication: a meta-analysis.

In intermittent claudication, pharmacologic drugs and invasive measures are indicated in patients who do not benefit from exercise training. To evaluate the therapeutic role of prostaglandins (PGs), especially of prostaglandin E1 (PGE1), for this indication, the author performed a meta-analysis of all published prospective, randomized, controlled clinical studies in which descriptive sample statistics of the pain-free walking distance (PFWD) and the maximum walking distance (MWD) were available. In total, 9 studies with PGE1 and 4 studies with other PGs (beraprost, iloprost, AS-013) that met these selection criteria could be analyzed. In patients treated with PGE1 (n = 344), PFWD increased significantly (p < 0.001) more (+107%) than in patients treated with other PGs (n = 402; +42%) or placebo (n = 470; +24%). Similar results were also found for the MWD. Side effects were significantly (p < 0.001) fewer with PGE1 therapy than with other PGs (14.0% vs 30.8% of patients). In conclusion, PGE1 proved to be the most effective and best tolerated of the PGs evaluated.