Comparative effects of cilostazol and other therapies for intermittent claudication

Many patients with peripheral arterial disease (PAD) have intermittent claudication or problems with ambulation and mobility. Exercise and smoking cessation are primary therapies for claudication, but drug treatment may provide additional benefit. The data supporting use of pentoxifylline for claudication are weak, and pentoxifylline is not generally accepted as efficacious. Cilostazol is a new drug for the treatment of claudication. It appears to modestly benefit walking ability and it has other potentially useful effects, including inhibition of platelet aggregation and beneficial effects on serum lipids. In a randomized, prospective, double-blind trial examining walking ability in patients with PAD with moderate-to-severe claudication, cilostazol was superior to both placebo and pentoxifylline.