Current and emerging drug treatment strategies for peripheral arterial disease.

INTRODUCTION: Peripheral artery disease (PAD) is a prevalent but underdiagnosed manifestation of atherosclerosis that has a worse prognosis than coronary artery disease. Patients with PAD are at heightened risk of both systemic cardiovascular adverse events and limb-related morbidity. There is insufficient awareness of its clinical manifestations, including intermittent claudication and critical limb ischemia and of its risk of adverse cardiovascular and limb outcomes. AREAS COVERED: The authors present the current knowledge concerning medications and their mechanism of action, landmark trials, and the evidence base behind the most commonly utilized pharmacological therapy including but not limited aspirin, clopidogrel, ticagrelor, warfarin, rivaroxaban, statins, angiotensin-converting enzyme inhibitors, Evolocumab and Ezetimibe. EXPERT OPINION: Relative to coronary artery disease, peripheral artery disease is an undertreated and under-investigated condition. The majority of the evidence base in the management of PAD is extrapolated from data subsets of large trials examining different conditions. This creates a paucity of management decisions based on trials powered for outcomes in PAD.