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Lege Artis Medicinae

OCTOBER 20, 2019

[Medical therapy of peripherial artery disease]

BENCZÚR Béla

[Care of PAD (peripherial arterial disease) is one of the most negligent area of cardiovascular diseases: on one hand patients suffering from PAD are the most uncared, less educated and health-minded population (it’s enough to keep in mind the high rate of smoking and alcohol-abuse among them) in addition the number of angiologists is insufficient for the treatment of PAD. Although detection of PAD would be easy as a widely applicable, cheap screening method, the ankle-brachial index is available which is an obligatory screening investigation in general care. Therapeutic options are better and better since cilostazol was launched we have an evidence-based treatment which can solve the symptoms, slower the progression which is strongly recommended (IA recommendation) in both American and Hungarian guidelines. Cilostazol, a PDE3-inhibitor has complex pharmacological effect but contraindicated in several clinical conditions as pentoxiphylline is not totally excluded from the therapeutic arsenal of PAD. The place of antiplatelet agents is well-defined in the most recent European guidelines in the treatment of PAD. The jumping development of interventional radiology beyond medical therapy contributed a lot to prevent limb amputations in the case of early detection of PAD. ]

Hypertension and nephrology

OCTOBER 20, 2018

[The actual aspects of the medical therapy of PAD patients after endovascular intervention. Through the eyes of an angiologist]

JASSÓ István

[After endovascular intervention in PAD the optimal medical therapy is essential for improving the patency and the quality of life as well as the cardiovascular risk reduction. According to the current guidelines the author gives an overview of the routine therapy and the possible advantages of longtermuse of cilostazol for these patients.]

Hypertension and nephrology

MAY 20, 2017

[Cilostazol is effective and safe option for the treatment of intermittent claudication. Results of the NOCLAUD study]

FARKAS Katalin, JÁRAI Zoltán, KOLOSSVÁRY Endre

[Intermittent claudication can seriously impair the patients’ quality of life. Cilostazol was registered in Hungary in 2014. This study aimed to evaluate the efficacy and safety of cilostazol in patients with intermittent claudication. 1405 patients were enrolled to the 6 months, multicenter, non-interventional trial. From the 1331 patients, who completed the study, the data of 674 patients were subjected to efficacy analysis. Pain free and maximal walking distance and the 6 minute walking test improved significantly at 3 months (78.65%, 65.23%, 56.09%; respectively, p<0.001), and a further increase was observed after 6 months treatment (129.74%, 107.2, 80.38% respectively, p<0.001). Adverse events occured in 7.26% of the patients. The most frequent adverse events were headache, diarrhea, dizziness, tachycardia or palpitation. 24 patients (1.7%) stopped cilostazol treatment because of side effects. 6 month cilostazol treatment significantly increased the walking distance in patients with intermittent claudication, without important safety problems.]

JUNE 20, 2017

Cilostazol is effective and safe option for the treatment of intermittent claudication. Results of the NOCLAUD study

FARKAS Katalin, JÁRAI Zoltán, KOLOSSVÁRY Endre

Intermittent claudication can seriously impair the patients’ quality of life. Cilostazol was registered in Hungary in 2014. This study aimed to evaluate the efficacy and safety of cilostazol in patients with intermittent claudication. 1405 patients were enrolled to the 6 months, multicenter, non-interventional trial. From the 1331 patients, who completed the study, the data of 674 patients were subjected to efficacy analysis. Pain free and maximal walking distance and the 6 minute walking test improved significantly at 3 months (78.65%, 65.23%, 56.09%; respectively, p<0.001), and a further increase was observed after 6 months treatment (129.74%, 107.2, 80.38% respectively, p<0.001). Adverse events occured in 7.26% of the patients. The most frequent adverse events were headache, diarrhea, dizziness, tachycardia or palpitation. 24 patients (1.7%) stopped cilostazol treatment because of side effects. 6 month cilostazol treatment significantly increased the walking distance in patients with intermittent claudication, without important safety problems.

Lege Artis Medicinae

JUNE 01, 2015

[Mechanism of action and role of cilostazol in treatment of peripheral arterial disease]

KOLTAI Katalin, BIRÓ Katalin, KOVÁCS Dávid, CSISZÁR Beáta, TÓTH Kálmán, KÉSMÁRKY Gábor

[Intermittent claudication is a typical symptom of lower extremity arterial disease. Cilostazol is a reversible, selective phosphodiesterase-3 inhibitor which has antiplatelet, antithrombotic and vasodilator effects. It is indicated to improve maximal and pain-free walking distance in patients with intermittent claudication in the absence of rest pain or peripheral tissue necrosis. It can be beneficial in diabetic patiens with intermittent claudication, as it has been proved to prevent the development of foot ulcers. In combination with acetyl-salicylic acid it may help maintain stent patency after endovascular intervention and stent implantation. Cilostazol is contraindicated in heart failure. With cilostazol, a clinically proven effective drug has become available in the treatment of intermittent claudication which could improve walking and life quality of patients.]

Lege Artis Medicinae

FEBRUARY 15, 2015

[Cilostazol in therapy of peripheral atherosclerotic patients]

MARTIS Gábor

[INTRODUCTION - Cilostazol is available in Hungary for patients with peripheral atherosclerotic disease (PAD) since June 2014. PATIENTS AND METHOD - In this prospective clinical data collection 68 patients were investigated with PAD-CI, treated with cilostazol. All patients were in stage of Fontaine II at the beginning of the study. Every patient has been able to control for at least three months. Two investigated groups have been treated with cilostazol. Group I: patients operated on lower extremity with femoropopliteal bypass earlier of this study and group II: patients with PAD but no arterial reconstruction in their medical record. Every patient got 100 mg cilostazol twice a day. Anticholesterol, platelet inhibition treatment have been continued in every case. No patients have taken pentoxifyllin. The end points of the data collection were the walking distance alteration (elongation) expressed in meter and the changing of the complaints of claudication intermittent. 61 patients have tolerated cilostazol treatment without side effects. Seven patients out of 68 have not tolerated it, that is why the treatment was suspended. Thirty-four out of 61 patients’ walking distance was elongated with at least 50 meters. 21 patients’ claudication improved between 50 to 100 meters and 12 patients’ walking distance improved more than 100 meters. CONCLUSION - The cilostazol presumably will be an unavoidable factor in the effective treatment of peripheral atherosclerotic disease. ]