近藤 ゆか

ASO, CAD, and CKD can be all manifestations of atherosclerosis, and the three conditions commonly occur together. Therefore, the goal of pharmacotherapy for patients with ASO is not only to relieve symptoms of the lower limbs but also to improve survival of the patients. First, we examined evidence for clinical utility of ASO drugs by searching publications reporting prospective randomized studies for ASO drugs with PubMed as well as reviewing the relevant documents submitted to the Food and Drug Administration in the United States. The benefits of cilostazol, beraprost, and ticlopidine have been shown for treating intermittent claudication, while beraprost and ticlopidine have been proven to decrease cardiovascular events. We also examined the safety of cilostazol, beraprost, and ticlopidine in patients with CAD and CKD. Caution should be exercised when cilostazol is administered to patients with moderate or severe CKD and possible CAD. Second, we investigated the current status of pharmacotherapy for patients with ASO by vascular specialists in 11 university hospitals. Beraprost was the most frequently used drug, and cilostazol was the second. Beraprost was more frequently used in patients with ASO and CAD or CKD than cilostazol.