LAUSR

OBJECTIVE To systematically evaluate the therapeutic effects of commonly used drugs for the treatment of intermittent claudication in patients with peripheral arterial diseases. METHODS We systematically searched bibliographic databases for randomized clinical trials published between 2000 and 2020, through China National Knowledge Infrastructure, WanFang Data, PubMed, Medline, Embase, and Cochrane library. Included studies focused on therapeutic effects of beraprost, clopidogrel, aspirin, sargogrelate and cilostazol, on treating intermittent claudication. The outcome measures were maximum walking distance, pain-free walking distance, ankle-brachial index and severe adverse events. Quality of included trials was evaluated by using the bias risk assessment tool recommended by Cochrane, after extracting data from the literatures. Stata was used to conduct network meta-analysis. RESULTS There were 27 randomized control trials included in the study, covering in total 9 491 patients. Network meta-analysis results showed that for maximum walking distance, better therapeutic effect was noted in using beraprost, sargogrelate and cilostazol. Beraprost, beraprost combined with aspirin and sargogrelate was better in improving pain-free walking distance than other drug uses. For ankle brachial index, cilostazol combined with clopidogrel, sargogrelate and beraprost had better therapeutic effects than others. The use of sargogrelate, beraprost and aspirin were associated with a lower ratio of severe adverse events, than the use of cilostazol and placebo. CONCLUSIONS Among the commonly used drugs for the treatment of intermittent claudication, beraprost and sargogrelate may have better efficacy in improving walking distance and ankle brachial index, with a beneficial effect on cardiovascular and cerebrovascular comorbidities.