TREATMENT WITH PENTOXIFYLLINE IN SYMPTOMATIC PERIPHERAL ARTERIAL DISEASE – WHERE DO WE STAND?

INTRODUCTION AND OBJECTIVES: Peripheral arterial disease (PAD) is common. It’s an important risk factor of cardiovascular events and has a negative impact in quality of life. Intermittent Claudication (IC) is the more frequent symptom of PAD. Medication, like pentoxifylline, has been used for symptomatic relieve of IC. But recently there are many studies that question its utility. The objective of this study is to review the role of pentoxifylline in IC (Evidence-based Medicine). METHODS: Systematic search of guidelines and systematic review (SR) with or without meta-analyses (MA) in National Guideline Clearinghouse, Canadian Medical Association, National Institute for Health and Care Excellence (NICE), Cochrane e MEDLINE® published in last ten years with MeSH keywords “pentoxifylline” and “peripheral arterial disease”. The quality of studies and the strength of recommendation (SOR) was determined by SORT scale of American Academy of Family Physicians. RESULTS AND DISCUSSION: There were find 246 articles. 2 guidelines were found with inclusion criteria, 2 MA and 1 SR. The evidence shows that pentoxifylline may have a role in treatment of IC. There is no sufficient evidence of good quality increase to recommend pentoxifylline in CI (SOR A), but it can be used as second line treatment in order to improve walk distance in CI as alternative to cilostazol (SOR A). Almost of the studies have poor quality and heterogeneity in terms of methods and in results, so more research is needed in this field.