Medical Management of Peripheral Arterial Disease
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tfinucane@jhmi.edu
Geriatric Center
Johns Hopkins Bayview Medical Center
Baltimore, Md
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ASPIRIN
- CILOSTAZOL
- CLOPIDOGREL
- DRUG COSTS
- INTERMITTENT CLAUDICATION
- PERIPHERAL VASCULAR DISEASES
To the Editor: In discussing medical treatment of PAD, Dr Hankey and colleagues1 state that “a meta-analysis of 8 [randomized controlled trials] involving 2702 patients demonstrated that cilostazol improved maximum walking distance and pain-free walking distance,” citing Thompson et al.2 However, in that study, the effect size was small, with increases of 50% and 67% in maximum walking distance and pain-free walking distance, respectively. Stated differently, if a patient could walk to first base before experiencing claudication, then with the addition of cilostazol, with its potential toxicity and at a cost in our pharmacy of $467.78 per month, he or she could round first and make it part of the way to second base.
Addressing effect size and cost data could help clinicians improve decision-making beyond a simple assertion of a drug's effectiveness for treating the condition.
Financial Disclosures: None reported.
