Evidence map›Paper›PMID 23034699›Full record

SynthesisThe British journal of surgery2012

Systematic review of the efficacy of cilostazol, naftidrofuryl oxalate and pentoxifylline for the treatment of intermittent claudication.

J W Stevens, E Simpson, S Harnan, H Squires, Y Meng, S Thomas, J Michaels, G Stansby

Registry-linked trialAbstract readComparative StudySystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in The British journal of surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03883412 (Effect of Exercise and/or Liraglutide on Vascular Dysfunction and Insulin Sensitivity in Type 2 Diabetes), which is not on this map. Cited by 37 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 7 pooled it
12.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03883412 phase4recruitingstarted 2019, after this paper: background citation

Effect of Exercise and/or Liraglutide on Vascular Dysfunction and Insulin Sensitivity in Type 2 Diabetes ( ZQL007)

Ran2019Enrolled60Registered outcomes6Posted comparisons0ConditionsType2 DiabetesArmsExercise, liraglutide
Open the trial in the graph
3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 7 syntheses or guidelines pooled it, 124 citations in OpenAlex.

  1. Cilostazol for intermittent claudication.The Cochrane database of systematic reviews · 2021
    Pooled it
  2. Pentoxifylline for intermittent claudication.The Cochrane database of systematic reviews · 2020
    Pooled it
  3. Pooled it
  4. Exercise training for intermittent claudication.Journal of vascular surgery · 2017
    Pooled it
  5. Guideline
  6. Pentoxifylline for intermittent claudication.The Cochrane database of systematic reviews · 2015
    Pooled it
  7. Cilostazol for intermittent claudication.The Cochrane database of systematic reviews · 2014
    Pooled it
  8. Trial
  9. Trial
  10. Article
  11. Article
  12. Review
  13. Review
  14. Article
  15. Review
  16. Article
  17. Review
  18. Primary care approach to calf cramps.Singapore medical journal · 2022
    Article
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

J W StevensCentre for Bayesian Statistics in Health Economics, University of Sheffield, UK. j.w.stevens@sheffield.ac.uk
E Simpson
S Harnan
H Squires
Y Meng
S Thomas
J Michaels
G Stansby
University of Sheffield · GBNewcastle University · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA systematic review and network meta-analysis was undertaken to consider the evidence for the efficacy and tolerability of placebo, cilostazol, naftidrofuryl oxalate and pentoxifylline in patients with intermittent claudication due to peripheral arterial disease (PAD).

methodsMEDLINE, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Conference Proceedings, BIOSIS, National Research Register and MetaRegister databases were searched. Eligible studies were randomized controlled trials (RCTs) and published systematic reviews of patients with intermittent claudication due to PAD and whose symptoms persisted despite a period of conservative management. Study selection was conducted by one reviewer with involvement from a clinician. Data were extracted by one reviewer with no blinding to authors or journal, and checked by a second reviewer. Outcome measures were maximum walking distance (MWD) and pain-free walking distance (PFWD).

resultsThe review identified 1876 citations; 26 RCTs met the inclusion criteria for the systematic review. Eleven trials provided data relevant for the meta-analysis. Naftidrofuryl oxalate was ranked first for both MWD and PFWD (probability of 0·947 and 0·987, respectively, of being the best treatment) followed by cilostazol and pentoxifylline. For naftidrofuryl oxalate, cilostazol and pentoxifylline, MWD increased by 60 (95 per cent credible interval 20 to 114) per cent, 25 (11 to 40) per cent and 11 (-1 to 24) per cent respectively relative to placebo, and PFWD increased by 49, 13 and 9 per cent.

conclusionNaftidrofuryl oxalate and cilostazol are both effective treatments for claudication; naftidrofuryl oxalate is likely to be the most effective, with minimal serious adverse events.

Indexed as

CilostazolHumansIntermittent ClaudicationNafronylPainPentoxifyllinePeripheral Vascular DiseasesRandomized Controlled Trials as TopicTetrazolesTreatment OutcomeVasodilator AgentsWalkingCilostazolNafronylPentoxifyllineTetrazolesVasodilator Agents

Identifiers

PMID23034699
OpenAlexW2085884676

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.