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[PMID]:29318581
[Au] Autor:Vietto V; Franco JV; Saenz V; Cytryn D; Chas J; Ciapponi A
[Ad] Endereço:Family and Community Medicine Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
[Ti] Título:Prostanoids for critical limb ischaemia.
[So] Source:Cochrane Database Syst Rev;1:CD006544, 2018 01 10.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Peripheral arterial occlusive disease (PAOD) is a common cause of morbidity and mortality due to cardiovascular disease in the general population. Although numerous treatments have been adopted for patients at different disease stages, no option other than amputation is available for patients presenting with critical limb ischaemia (CLI) unsuitable for rescue or reconstructive intervention. In this regard, prostanoids have been proposed as a therapeutic alternative, with the aim of increasing blood supply to the limb with occluded arteries through their vasodilatory, antithrombotic, and anti-inflammatory effects. This is an update of a review first published in 2010. OBJECTIVES: To determine the effectiveness and safety of prostanoids in patients with CLI unsuitable for rescue or reconstructive intervention. SEARCH METHODS: For this update, the Cochrane Vascular Information Specialist searched the Specialised Register (January 2017) and the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1). In addition, we searched trials registries (January 2017) and contacted pharmaceutical manufacturers, in our efforts to identify unpublished data and ongoing trials. SELECTION CRITERIA: Randomised controlled trials describing the efficacy and safety of prostanoids compared with placebo or other pharmacological control treatments for patients presenting with CLI without chance of rescue or reconstructive intervention. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials, assessed trials for eligibility and methodological quality, and extracted data. We resolved disagreements by consensus or by consultation with a third review author. MAIN RESULTS: For this update, 15 additional studies fulfilled selection criteria. We included in this review 33 randomised controlled trials with 4477 participants; 21 compared different prostanoids versus placebo, seven compared prostanoids versus other agents, and five conducted head-to-head comparisons using two different prostanoids.We found low-quality evidence that suggests no clear difference in the incidence of cardiovascular mortality between patients receiving prostanoids and those given placebo (risk ratio (RR) 0.81, 95% confidence interval (CI) 0.41 to 1.58). We found high-quality evidence showing that prostanoids have no effect on the incidence of total amputations when compared with placebo (RR 0.97, 95% CI 0.86 to 1.09). Adverse events were more frequent with prostanoids than with placebo (RR 2.11, 95% CI 1.79 to 2.50; moderate-quality evidence). The most commonly reported adverse events were headache, nausea, vomiting, diarrhoea, flushing, and hypotension. We found moderate-quality evidence showing that prostanoids reduced rest-pain (RR 1.30, 95% CI 1.06 to 1.59) and promoted ulcer healing (RR 1.24, 95% CI 1.04 to 1.48) when compared with placebo, although these small beneficial effects were diluted when we performed a sensitivity analysis that excluded studies at high risk of bias. Additionally, we found evidence of low to very low quality suggesting the effects of prostanoids versus other active agents or versus other prostanoids because studies conducting these comparisons were few and we judged them to be at high risk of bias. None of the included studies assessed quality of life. AUTHORS' CONCLUSIONS: We found high-quality evidence showing that prostanoids have no effect on the incidence of total amputations when compared against placebo. Moderate-quality evidence showed small beneficial effects of prostanoids for rest-pain relief and ulcer healing when compared with placebo. Additionally, moderate-quality evidence showed a greater incidence of adverse effects with the use of prostanoids, and low-quality evidence suggests that prostanoids have no effect on cardiovascular mortality when compared with placebo. None of the included studies reported quality of life measurements. The balance between benefits and harms associated with use of prostanoids in patients with critical limb ischaemia with no chance of reconstructive intervention is uncertain; therefore careful assessment of therapeutic alternatives should be considered. Main reasons for downgrading the quality of evidence were high risk of attrition bias and imprecision of effect estimates.
[Mh] Termos MeSH primário: Isquemia/tratamento farmacológico
Perna (Membro)/irrigação sanguínea
Doenças Vasculares Periféricas/tratamento farmacológico
Prostaglandinas/uso terapêutico
[Mh] Termos MeSH secundário: Alprostadil/uso terapêutico
Amputação/estatística & dados numéricos
Epoprostenol/uso terapêutico
Seres Humanos
Iloprosta/uso terapêutico
Isquemia/mortalidade
Perna (Membro)/cirurgia
Úlcera da Perna/tratamento farmacológico
Nafronil/uso terapêutico
Ácidos Nicotínicos/uso terapêutico
Pentoxifilina/uso terapêutico
Prostaglandinas/efeitos adversos
Ensaios Clínicos Controlados Aleatórios como Assunto
Vasodilatadores/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Nicotinic Acids); 0 (Prostaglandins); 0 (Vasodilator Agents); 42H8PQ0NMJ (Nafronyl); A99MK953KZ (Inositol Niacinate); DCR9Z582X0 (Epoprostenol); F5TD010360 (Alprostadil); JED5K35YGL (Iloprost); SD6QCT3TSU (Pentoxifylline)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD006544.pub3


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[PMID]:26742197
[Au] Autor:Marcial JM; Pérez R; Vargas P; Franqui-Rivera H
[Ti] Título:Non-Invasive Therapy of Peripheral Arterial Disease.
[So] Source:Bol Asoc Med P R;107(3):52-7, 2015 Jul-Sep.
[Is] ISSN:0004-4849
[Cp] País de publicação:Puerto Rico
[La] Idioma:eng
[Ab] Resumo:Peripheral arterial disease (PAD) is a significant cause of morbidity and mortality worldwide. Lifestyle changes, like the cessation of the use of tobacco as well as a modification of dietary and exercise habits, can be the most cost-effective interventions in patients with PAD. Smocking cessation is the most important intervention, since it increases survival in these patients. Antiplatelet therapy is an essential component in the treatment of peripheral arterial disease (PAD) of the lower extremities. In addition to delaying arterial obstructive progression, these agents are most usefull in reducing adverse cardiovascular events such as non-fatal myocardial infarction (MI), stroke and vascular death. Mainstay of treatment continues to be aspirin monotherapy (75-325mg daily). Current treatment for lower extremity PAD is directed towards the relief of symptoms and improvement in QoL. The two agents which have consistently been found to be most efficient in achieving these goals are cilostazol and naftidrofuryl oxalate. Naftidrofuryl oxalate may emerge as the most efficient and cost-effective treatment for symptom relief.
[Mh] Termos MeSH primário: Doença Arterial Periférica/terapia
[Mh] Termos MeSH secundário: Anti-Hipertensivos/uso terapêutico
Ensaios Clínicos como Assunto
Dieta com Restrição de Gorduras
Dieta Redutora
Método Duplo-Cego
Quimioterapia Combinada
Drogas em Investigação/uso terapêutico
Terapia por Exercício
Seres Humanos
Hipoglicemiantes/uso terapêutico
Hipolipemiantes/uso terapêutico
Metanálise como Assunto
Estudos Multicêntricos como Assunto
Nafronil/uso terapêutico
Doença Arterial Periférica/dietoterapia
Doença Arterial Periférica/tratamento farmacológico
Inibidores da Agregação de Plaquetas/uso terapêutico
Abandono do Hábito de Fumar
Tetrazóis/uso terapêutico
Terapias em Estudo
Perda de Peso
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antihypertensive Agents); 0 (Drugs, Investigational); 0 (Hypoglycemic Agents); 0 (Hypolipidemic Agents); 0 (Platelet Aggregation Inhibitors); 0 (Tetrazoles); 42H8PQ0NMJ (Nafronyl); N7Z035406B (cilostazol)
[Em] Mês de entrada:1602
[Cu] Atualização por classe:160108
[Lr] Data última revisão:
160108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160109
[St] Status:MEDLINE


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[PMID]:25637225
[Au] Autor:Vyskocil V; Koudela K; Pavelka T; Stajdlova K; Suchy D
[Ad] Endereço:Department of Orthopaedic Surgery, Faculty Hospital Plzen, Alej Svobody 80, Plzen, 304 60, Czech Republic. vyskocil@fnplzen.cz.
[Ti] Título:Incidentally diagnosed melorheostosis of upper limb: case report.
[So] Source:BMC Musculoskelet Disord;16:2, 2015 Jan 31.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Melorheostosis is quite a rare bone disease with still unclear ethiology. Although multifocal affection is highly debilitating with unfavorable prognosis, there is no clear consensus about therapeutical approach. There is still insufficient evidence in the literature for almost a century after the first description. Affected bone has a typical appearance of melting wax. Diagnosis is usually incidental with pain as a leading symptom. Diagnosis itself is relatively easy, routine X-ray examination is sufficient. Even though it could be easily overlooked and mistaken with other diseases. Melorheostosis is incurable, the therapy is mostly focused on maintaining patient quality of life. Presented case is unique in terms of extent of the affection (index finger, metacarp shaft, carpal bones, forearm, humerus and whole scapula) in combination with osteopoikilotic islands in other 3 regions (vertebrae, manubrium sterni and left collar bone). Currently there is only one such a case published in the literature (Campbell), but without osteopoikilotic islands. CASE PRESENTATION: Melorheostosis was diagnosed in 26-year old female after injury as an incidental finding. This was quite surprising as the patient already suffered by limited movement in the upper limb and pain before the injury. Detailed examination were performed to confirm the diagnosis, no family history was found. Pharmacotherapy with bisphosphonates, non-steroidal antirheumatics and vasodilatans/rheologic drugs seemed to be effective to maintain the relatively good quality of patient life and good performance in daily routine. Questionable is further development of patient performance status and sustainability of conservative treatment in the long term follow up. CONCLUSION: Conservative treatment with bisphopshonates and COX-2 inhibitors in combination with naftidrofuryl can delay surgery solution.
[Mh] Termos MeSH primário: Melorreostose/diagnóstico
[Mh] Termos MeSH secundário: Absorciometria de Fóton
Adulto
Vértebras Cervicais/diagnóstico por imagem
Inibidores de Ciclo-Oxigenase 2/uso terapêutico
Difosfonatos/uso terapêutico
Quimioterapia Combinada
Feminino
Antebraço/diagnóstico por imagem
Mãos/diagnóstico por imagem
Seres Humanos
Melorreostose/tratamento farmacológico
Nafronil/uso terapêutico
Tomografia Computadorizada por Raios X
Extremidade Superior
Imagem Corporal Total
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cyclooxygenase 2 Inhibitors); 0 (Diphosphonates); 42H8PQ0NMJ (Nafronyl)
[Em] Mês de entrada:1512
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150201
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-015-0455-z


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[PMID]:25490354
[Au] Autor:Kuznetsov MR; Kosykh IV; Iumin SM; Kunitsyn NV; Kuznetsova VF; Tolstikhin VIu; Magnitskii LA
[Ti] Título:[Use of naftidrofuryl in angiology].
[So] Source:Angiol Sosud Khir;20(4):27-35, 2014.
[Is] ISSN:1027-6661
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:The review analyses the role of serotonin in the development of pathological processes in angiological patients, showing its negative role in aggravating chronic and acute ischaemia of various organs (brain, myocardium, extremities) both at the expense of vasoconstriction and due to an increase in blood platelet aggregation of blood platelets and erythrocytes, followed by analysis of clinical efficacy of naftidrofuryl) - serotonin 5-HT2 receptor antagonist. Results of numerous randomized trials confirmed its efficacy and safety in treatment of angiological patients, being superior to other vasotropic drugs (cilostazol, pentoxyphyllin, nicotinic acid).
[Mh] Termos MeSH primário: Isquemia
Nafronil/farmacologia
Serotonina/metabolismo
Vasoconstrição
[Mh] Termos MeSH secundário: Seres Humanos
Isquemia/classificação
Isquemia/tratamento farmacológico
Isquemia/etiologia
Isquemia/metabolismo
Isquemia/fisiopatologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Receptores 5-HT2 de Serotonina/metabolismo
Resultado do Tratamento
Vasoconstrição/efeitos dos fármacos
Vasoconstrição/fisiologia
Vasodilatadores/farmacologia
[Pt] Tipo de publicação:ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Receptors, Serotonin, 5-HT2); 0 (Vasodilator Agents); 333DO1RDJY (Serotonin); 42H8PQ0NMJ (Nafronyl)
[Em] Mês de entrada:1502
[Cu] Atualização por classe:141216
[Lr] Data última revisão:
141216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141210
[St] Status:MEDLINE


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[PMID]:25012728
[Au] Autor:Hong H; Mackey WC
[Ad] Endereço:Tufts University School of Medicine, Boston, Massachusetts. Electronic address: hhhong87@gmail.com.
[Ti] Título:The limits of evidence in drug approval and availability: a case study of cilostazol and naftidrofuryl for the treatment of intermittent claudication.
[So] Source:Clin Ther;36(8):1290-301, 2014 Aug 01.
[Is] ISSN:1879-114X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Despite numerous efforts to develop effective medications for the treatment of intermittent claudication (IC) over the past 4 decades, a gold standard medical management option has yet to be defined. Although not life-threatening, IC interferes with mobility and activities of daily living, significantly impairing quality of life and potentially causing depression. Cilostazol, the leading pharmacologic agent for IC in the United States, was approved by the US Food and Drug Administration (FDA) in 1999 based on controversial data. Meanwhile, naftidrofuryl, the first-line pharmacologic agent for IC in the United Kingdom and Europe, has never been approved by the FDA and therefore is not available in the United States. The clinical data for cilostazol and naftidrofuryl are plagued by flaws related to lack of protocol standardization, objective endpoints, and strict eligibility criteria in study subjects, making identification of a true treatment effect impossible. Furthermore, no prospective randomized trial comparing the efficacy of cilostazol and naftidrofuryl has been conducted, because the manufacturers of these agents have much to lose and little to gain from such a study. OBJECTIVE: This article provides an overview of the pharmacology of cilostazol and naftidrofuryl, and the clinical studies leading to their approval and clinical acceptance. It further explores the possible sources of bias in analyzing these clinical trials, some of which have been brought to light by the National Institute for Health and Clinical Excellence (NICE) of the United Kingdom in its technology appraisal guidance. It also speculates the ways in which economic incentives may affect drug-marketing decisions. METHODS: A literature review of pharmacology and clinical trials for cilostazol and naftidrofuryl was performed in PubMed. The majority of included clinical trials were initially identified through the most recent Cochrane review articles as well as the FDA's approval packet for cilostazol. The technology appraisal guidance of the National Institute for Health and Care Excellence of the United Kingdom and the manufacturer's response to this guidance document were located via an online search engine. FINDINGS: The clinical data for cilostazol and naftidrofuryl are plagued by flaws related to lack of protocol standardization, objective endpoints, and strict eligibility criteria in study subjects, making identification of a true treatment effect difficult. Furthermore, no prospective randomized trial comparing the efficacy of cilostazol and naftidrofuryl has been conducted. IMPLICATIONS: The history of the evaluation, approval, and marketing of these drugs illustrates the limitations of data in the regulatory approval and marketing of agents whose benefit is subjective and difficult to quantify. Implementation of a standardized protocol with strict eligibility criteria, objective quantifiable measurement of drug effect, and validated endpoints will eventually allow development of an ideal pharmacotherapy for IC.
[Mh] Termos MeSH primário: Ensaios Clínicos como Assunto/normas
Claudicação Intermitente/tratamento farmacológico
Nafronil/uso terapêutico
Projetos de Pesquisa/normas
Tetrazóis/uso terapêutico
Vasodilatadores/uso terapêutico
[Mh] Termos MeSH secundário: Aprovação de Drogas
Determinação de Ponto Final/normas
Seres Humanos
Nafronil/farmacologia
Tetrazóis/farmacologia
Reino Unido
Estados Unidos
Vasodilatadores/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Tetrazoles); 0 (Vasodilator Agents); 42H8PQ0NMJ (Nafronyl); N7Z035406B (cilostazol)
[Em] Mês de entrada:1603
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140712
[St] Status:MEDLINE


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[PMID]:23378195
[Au] Autor:Meng Y; Squires H; Stevens JW; Simpson E; Harnan S; Thomas S; Michaels J; Stansby G; O'Donnell ME
[Ad] Endereço:1School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.
[Ti] Título:Cost-effectiveness of cilostazol, naftidrofuryl oxalate, and pentoxifylline for the treatment of intermittent claudication in people with peripheral arterial disease.
[So] Source:Angiology;65(3):190-7, 2014 Mar.
[Is] ISSN:1940-1574
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We assessed the cost-effectiveness of cilostazol, naftidrofuryl oxalate, and pentoxifylline for intermittent claudication due to peripheral arterial disease (PAD) in adults whose symptoms continue despite a period of conventional management. A Markov decision model was developed to assess the lifetime costs and benefits of each vasoactive drug compared to no vasoactive drug and with each other. Regression analysis was undertaken to model the relationship between maximum walking distance and utility. Resource use data were sourced from the literature and sensitivity analyses were undertaken. Naftidrofuryl oxalate is more effective and less costly than cilostazol and pentoxifylline and has an estimated cost per quality-adjusted life year gained of around £6070 compared to no vasoactive drug. The analysis uses effectiveness evidence from a network meta-analysis. In contrast to previous guidelines recommending cilostazol, the analysis suggests that naftidrofuryl oxalate is the only vasoactive drug for PAD which is likely to be cost-effective.
[Mh] Termos MeSH primário: Claudicação Intermitente/tratamento farmacológico
Nafronil/uso terapêutico
Pentoxifilina/uso terapêutico
Doença Arterial Periférica/complicações
Tetrazóis/uso terapêutico
Vasodilatadores/uso terapêutico
[Mh] Termos MeSH secundário: Análise Custo-Benefício
Técnicas de Apoio para a Decisão
Seres Humanos
Claudicação Intermitente/etiologia
Claudicação Intermitente/mortalidade
Cadeias de Markov
Nafronil/economia
Pentoxifilina/economia
Tetrazóis/economia
Vasodilatadores/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Tetrazoles); 0 (Vasodilator Agents); 42H8PQ0NMJ (Nafronyl); N7Z035406B (cilostazol); SD6QCT3TSU (Pentoxifylline)
[Em] Mês de entrada:1403
[Cu] Atualização por classe:140131
[Lr] Data última revisão:
140131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130205
[St] Status:MEDLINE
[do] DOI:10.1177/0003319712474335


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[PMID]:24227374
[Au] Autor:Roset PN
[Ad] Endereço:Medical Department, Ferrer Internacional, Barcelona, 08029, Spain. proset@ferrergrupo.com.
[Ti] Título:Systematic review of the efficacy of cilostazol, naftidrofuryl oxalate and pentoxifylline for the treatment of intermittent claudication (Br J Surg 2012; 99: 1630-1638).
[So] Source:Br J Surg;100(13):1838, 2013 Dec.
[Is] ISSN:1365-2168
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Claudicação Intermitente/tratamento farmacológico
Nafronil/uso terapêutico
Pentoxifilina/uso terapêutico
Doenças Vasculares Periféricas/complicações
Tetrazóis/uso terapêutico
Vasodilatadores/uso terapêutico
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:COMMENT; LETTER
[Nm] Nome de substância:
0 (Tetrazoles); 0 (Vasodilator Agents); 42H8PQ0NMJ (Nafronyl); SD6QCT3TSU (Pentoxifylline)
[Em] Mês de entrada:1401
[Cu] Atualização por classe:131114
[Lr] Data última revisão:
131114
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:131115
[St] Status:MEDLINE
[do] DOI:10.1002/bjs.9357


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[PMID]:24227373
[Au] Autor:Stevens JW; Simpson E; Harnan S; Squires H; Meng Y; Thomas S; Michaels J; Stansby G
[Ad] Endereço:Centre for Bayesian Statistics in Health Economics, University of Sheffield, Regent Court, Sheffield, S1 4DA, UK.
[Ti] Título:Authors' reply: systematic review of the efficacy of cilostazol, naftidrofuryl oxalate and pentoxifylline for the treatment of intermittent claudication (Br J Surg 2012; 99: 1630-1638).
[So] Source:Br J Surg;100(13):1838-9, 2013 Dec.
[Is] ISSN:1365-2168
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Claudicação Intermitente/tratamento farmacológico
Nafronil/uso terapêutico
Pentoxifilina/uso terapêutico
Doenças Vasculares Periféricas/complicações
Tetrazóis/uso terapêutico
Vasodilatadores/uso terapêutico
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:COMMENT; LETTER
[Nm] Nome de substância:
0 (Tetrazoles); 0 (Vasodilator Agents); 42H8PQ0NMJ (Nafronyl); SD6QCT3TSU (Pentoxifylline)
[Em] Mês de entrada:1401
[Cu] Atualização por classe:131114
[Lr] Data última revisão:
131114
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:131115
[St] Status:MEDLINE
[do] DOI:10.1002/bjs.9358


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[PMID]:23860108
[Au] Autor:Melzer J; Saller R
[Ad] Endereço:Institut für Naturheilkunde, Universitätsspital Zürich, Schweiz. joerg.melzer@usz.ch
[Ti] Título:[Clinical studies in peripheral arterial occlusive disease: update from the aspects of a meta-narrative review].
[Ti] Título:Klinische Studien bei peripherer arterieller Verschlusskrankheit: Update unter den Aspekten eines meta-narrativen Reviews..
[So] Source:Forsch Komplementmed;20 Suppl 2:17-21, 2013.
[Is] ISSN:1661-4127
[Cp] País de publicação:Switzerland
[La] Idioma:ger
[Ab] Resumo:BACKGROUND: Atherosclerosis is a systemic disease. Its association with the metabolic syndrome requires a multimodal therapy setting, to alleviate symptoms and for primary and secondary prevention. In the planning of the therapy, information about evidence of the interventions and a rationale for reasonable combinations are important. METHOD: For compiling a meta-narrative review (MNR) on the evidence of complementary and conventional pharmaco-therapy in peripheral arterial occlusive disease (PAOD), the literature was searched for meta-analyses of randomized controlled trials (RCTs). These were evaluated taking into account network-pharmacological aspects and research parameters. RESULTS: 4 suitable meta-analyses were found. In comparison to placebo, treatments with verum showed a significant improvement of the maximum walking distance of 63.5 m (95% confidence interval (CI) 27.11-99.91 m; Padma 28, Tibetan Formula), 41.3 m (95% CI -7.1-89.7 m; cilostazol, phosphodiesterase IIl inhibitor), 43.8 m (95% CI 14.1-73.6 m; pentoxifylline, rheological drug), and 71.2 m (95% CI 13.3-129.0 m; naftidrofuryl, rheological drug). Only for Padma 28, clinical relevance, defined as an increase of the maximum walking distance by >100 m, was analyzed and reached by 18.2% of the verum and 2.1% of the placebo patients (odds ratio 10; 95% CI 3.03-33.33). 1 conventional and 1 complementary drug additionally showed to have significant pleiotropic effects (Padma 28 and cilostazol (e.g. reduction of triglycerides)). CONCLUSIONS: According to meta-analytic evidence, naftidrofuryl and Padma 28 show clinically relevant efficacy for the treatment of early stages of PAOD. The extent to which the theoretically possible combination of different drugs contributes to improve the systemic disease under a network-pharmacological rationale remains to be shown in a multi-armed RCT.
[Mh] Termos MeSH primário: Arteriopatias Oclusivas/tratamento farmacológico
Terapias Complementares
Medicina Tradicional Tibetana
Fitoterapia
[Mh] Termos MeSH secundário: Arteriopatias Oclusivas/sangue
Seres Humanos
Claudicação Intermitente/sangue
Claudicação Intermitente/tratamento farmacológico
Nafronil/uso terapêutico
Pentoxifilina/uso terapêutico
Extratos Vegetais/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Tetrazóis/uso terapêutico
Triglicerídeos/sangue
Caminhada
[Pt] Tipo de publicação:COMPARATIVE STUDY; ENGLISH ABSTRACT; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Plant Extracts); 0 (Tetrazoles); 0 (Triglycerides); 122879-13-4 (Padma 28); 42H8PQ0NMJ (Nafronyl); N7Z035406B (cilostazol); SD6QCT3TSU (Pentoxifylline)
[Em] Mês de entrada:1404
[Cu] Atualização por classe:130717
[Lr] Data última revisão:
130717
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130718
[St] Status:MEDLINE
[do] DOI:10.1159/000351720


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[PMID]:23254471
[Au] Autor:Kim MJ; Lee JS; Kim SW
[Ad] Endereço:Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757, Korea.
[Ti] Título:Acute kidney injury associated with nafronyl oxalate overdose.
[So] Source:Clin Exp Nephrol;17(3):437-8, 2013 Jun.
[Is] ISSN:1437-7799
[Cp] País de publicação:Japan
[La] Idioma:eng
[Mh] Termos MeSH primário: Lesão Renal Aguda/induzido quimicamente
Nafronil/envenenamento
[Mh] Termos MeSH secundário: Oxalato de Cálcio/toxicidade
Cristalização
Overdose de Drogas
Seres Humanos
Hiperoxalúria/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
2612HC57YE (Calcium Oxalate); 42H8PQ0NMJ (Nafronyl)
[Em] Mês de entrada:1401
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121221
[St] Status:MEDLINE
[do] DOI:10.1007/s10157-012-0752-x



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