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Pharmacological treatment of patients with chronic critical limb ischemia: L-propionyl-carnitine enhances the short-term effects of PGE-1.

AbstractPURPOSE:
To evaluate the therapeutic effects of L-propionyl-carnitine (LPC) in patients with critical limb ischemia (CLI), as defined by the TASC guidelines.
METHODS:
The study, double-blinded, randomised, assessed intravenous infusion of LPC 1.2 g/day in combination with PGE-1, 60 mg/day (LPC group: 37 patients), or PGE-1 only (control group: 38 patients) in a total of 75 patients suffering from CLI. Treatment duration was 20 days. We evaluated rest pain, maximum walking distance (MWD) and skin ulcer size.
RESULTS:
In both groups we observed a significant reduction in pain score and ulcer size and an increase in MWD. In the patients treated with the combination, the improvement was greater: median value for pain score decreased from 2.75 to 0.85 in the LPC group and from 2.51 to 1.71 in the control group; MWD increased from 55 M to 130 M in the LPC group, and from 55 M to 102 M in the control group; median decrease of ulcer size was significantly greater in patients treated with LPC + PGE1.
CONCLUSIONS:
Our study shows that LPC, whose effectiveness on claudication is already known, has favourable effects in patients with CLI, since it reinforces the effects produced by PGE-1.
AuthorsGlauco Milio, Giuseppina Novo, Caterina Genova, Piero Luigi Almasio, Salvatore Novo, Antonio Pinto
JournalCardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy (Cardiovasc Drugs Ther) Vol. 23 Issue 4 Pg. 301-6 (Aug 2009) ISSN: 1573-7241 [Electronic] United States
PMID19548076 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Cardiotonic Agents
  • Vasodilator Agents
  • propionylcarnitine
  • Alprostadil
  • Carnitine
Topics
  • Aged
  • Alprostadil (pharmacology, therapeutic use)
  • Cardiotonic Agents (pharmacology, therapeutic use)
  • Carnitine (analogs & derivatives, pharmacology, therapeutic use)
  • Chronic Disease
  • Double-Blind Method
  • Drug Synergism
  • Drug Therapy, Combination
  • Female
  • Humans
  • Infusions, Intravenous
  • Ischemia (drug therapy, physiopathology)
  • Leg (blood supply, pathology)
  • Leg Ulcer (drug therapy, etiology)
  • Male
  • Middle Aged
  • Pain (drug therapy, etiology)
  • Treatment Outcome
  • Vasodilator Agents (pharmacology, therapeutic use)
  • Walking

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