Anti-PAD drug found to have lipid modifying effects

Cilostazol, a drug popularly known for its antiplatelet effect preventing the formation of blood clots in the body’s blood vessels, has also been shown to have favorable effects on the body’s lipid or cholesterol profile, particularly the high density lipoprotein (HDL) and triglycerides.

HDL is also known as the good type of cholesterol, while triglycerides are a type of fat which when increased can also be associated with increased risk of heart attack and stroke.

Results of the study published in the journal Arteriosclerosis, Thrombosis and Vascular Biology showed that 12 weeks of therapy with cilostazol 100 mg increased the level of HDL level by 10 percent.

Furthermore, triglyceride level was decreased by 15 percent.

Levels of the bad fats, low density lipoprotein and lipoprotein A, were unaffected.

The triglyceride-lowering effect of cilostazol is believed to have a significant effect in the treatment of heart disease, particularly in diabetics who are prone to have elevated triglycerides. Diabetes, by itself, is now considered a heart-disease equivalent.

The results of the study are also significant because current treatment guidelines recommend aggressive cholesterol-lowering and risk-factor modification in individuals with known coronary heart disease and other diseases of the blood vessels.

Aside from improving the lipid profile of patients, earlier studies showed that cilostazol can improve the symptoms of peripheral arterial disease (PAD), a disease which occludes the arteries in the lower extremities.

Intermittent claudication is the most common symptom of PAD and is usually felt as pain in the muscles of the legs and thighs when walking, and relieved with rest.

It may also be felt as fatigue, numbness, or a cramping sensation of the legs after walking a certain distance. Severe PAD can lead to gangrene and need to amputate the affected extremity.

In the United States, eight trials were done to test the efficacy of cilostazol versus placebo in the treatment of intermittent claudication.

In these trials, patients were either given cilostazol 50mg 2 tabs bid/day, 100mg bid/day or placebo for 12 to 24 months.

Treadmill test were done to determine improvement in walking distances.

Results showed that those taking cilostazol experienced an improvement in maximal walking distance compared to those given placebo or dummy pills.

The maximal walking distance of cilostazol patients improved by 44 to 50 percent compared to the 21 percent improvement achieved by patients taking placebo.

Furthermore, changes in pain-free walking distance showed a similar pattern to maximal walking distance and were significantly greater for cilostazol patients.

Many clinicians believe that cilostazol’s lipid-modifying effects, combined with its improvement of intermittent claudication, are important reasons to consider cilostazol as the preferred drug for the management of PAD.

Patients are cautioned, however, that cilostazol is a prescription medicine and should only be used upon their doctor’s recommendation.

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For inquiries on PAD and the I-PAD Awareness campaign, call the PAD Connect Hotline at 811-i-PAD for Metro Manila (811-4-723) or 1-800-1888-i-PAD for provincial area (1-800-1888—4723) or visit www.otsuka.com.ph.