A systematic review and economic evaluation of cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease

Squires H, Simpson E, Meng Y, Harnan S, Stevens JW, Wong R, Thomas S, Michaels J, Stansby G
Record ID 32011000769
English
Authors' objectives:

To assess the effectiveness and cost-effectiveness of the following vasoactive drugs for IC due to PAD in adults whose symptoms continue despite a period of conservative management:

cilostazol
naftidrofuryl oxalate
pentoxifylline
inositol nicotinate.

Authors' recommendations: Naftidrofuryl oxalate and cilostazol are both effective treatments for this patient population, with minimal SAEs; however, naftidrofuryl oxalate is the only treatment with an incremental cost per QALY gained below £20,000 compared with no vasoactive drug. There is, however, uncertainty regarding long-term effectiveness, and hence a trial comparing the long-term effectiveness (beyond 24 weeks) of cilostazol, naftidrofuryl oxalate and placebo would be beneficial, which should collect utility data as well as walking distance outcomes. It would also be useful to compare the outcomes associated with naftidrofuryl oxalate with those associated with supervised exercise programmes and other treatments, such as angioplasty. Importantly, there are currently no long-term safety trials for naftidrofuryl oxalate; however, clinical experts suggest that the mechanism of the drugs is such that no long-term impacts on cardiovascular events or mortality would be expected.
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk/2246
Year Published: 2011
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Humans
  • Inositol
  • Nafronyl
  • Peripheral Vascular Diseases
  • Intermittent Claudication
  • Nicotinic Acids
  • Pentoxifylline
  • Tetrazoles
  • Vasodilator Agents
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2011 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.