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Adjunctive pharmacotherapies for intermittent claudication—NICE guidance
  1. Joseph Shalhoub,
  2. Alun H Davies
  1. Academic Section of Vascular Surgery, Imperial College London, London, UK
  1. Correspondence to Alun H Davies, Academic Section of Vascular Surgery, Imperial College London, London, UK; a.h.davies{at}imperial.ac.uk

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There are a number of adjunctive pharmacotherapies available for individuals with peripheral arterial disease and intermittent claudication, in whom appropriate risk factor modification and antiplatelet treatment have been initiated. These include cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate, which have vasodilatation among their mechanisms of action and have been the subject of recent technology appraisal guidance offered by the National Institute for Health and Clinical Excellence (NICE).1 The guidance offered was based upon systematic review, meta-analysis and cost-effectiveness analysis and is summarised in box 1.

Box 1

Summary of NICE guidelines1

For individuals with peripheral arterial disease and intermittent claudication, where vasodilator treatment is considered appropriate:

  • Naftidrofuryl oxalate is recommended as a treatment option, started with the least costly licenced preparation

  • Cilostazol, pentoxyfylline and inositol nicotinate are not recommended in this context

  • If cilostazol, pentoxyfylline and inositol nicotinate are currently …

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