Drug curbs pain due to leg artery disease

NEW YORK (Reuters Health) - People who experience leg pain caused by narrowed arteries in their legs -- a condition called intermittent claudication -- can find some relief by taking the drug naftidrofuryl, a review of published studies indicates.

People with intermittent claudication have 37 percent more pain-free walking if they take naftidrofuryl three times a day than those taking inactive placebo, researchers report in The Cochrane Library, a publication of the Cochrane Collaboration, which publishes systematic reviews of the effectiveness of medical practice.

In addition, 55 percent of patients taking naftidrofuryl improved, while only 30 percent of people on placebo treatments improved. Naftidrofuryl is used to treat circulatory problems.

In patients with intermittent claudication, "it would make sense to give naftidrofuryl alongside recommending lifestyle changes such as stopping smoking, physical exercise and also prescribing anti-platelet drugs and statins," Dr. Tine de Backer at Ghent University in Belgium, who headed the research team, noted in a statement.

The chief symptoms of intermittent claudication are pain, cramping, or a sense of fatigue in leg muscles that increase with walking. The condition, which affects mostly older people, occurs when fatty deposits lead to hardening and narrowing of arteries supplying the legs. This makes it less easy for blood to carry oxygen and nutrients to the muscles or clear waste products away.

While stopping smoking and gently increasing exercise can reduce symptoms, interest has also been focused on some drug treatments.

Although prescribed for intermittent claudication since 1968, data regarding naftidrofuryl's efficacy are inconclusive, the Cochrane team notes.

To evaluate the data more rigorously, they identified and reviewed seven randomized, placebo controlled studies involving more than 1200 patients that compared naftidrofuryl 200 milligrams three times daily versus placebo.

After 6 months' treatment, average improvement in pain-free walking distance was 37 percent greater in the naftidrofuryl group than in the placebo group. Significantly more patients receiving active treatment were considered responders based on a 50 percent improvement in pain-free walking distance (55 percent vs 30 percent).

Trial reports and post-marketing surveillance support the safety of naftidrofuryl, de Backer's team reports, with side effects limited to minor stomach symptoms.

SOURCE: The Cochrane Library, published online April 16, 2008.