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5-羟色胺2A受体拮抗剂沙格雷酯对间歇性跛行患者步行能力的影响:采用步行障碍问卷进行评估

Effects of the 5-HT2A Antagonist Sarpogrelate on Walking Ability in Patients with Intermittent Claudication as Measured Using the Walking Impairment Questionnaire.

作者信息

Matsuo Hiroshi, Shigematsu Hiroshi

机构信息

Matsuo Cardiovascular Clinic, Osaka, Japan.

出版信息

Ann Vasc Dis. 2008;1(2):102-10. doi: 10.3400/avd.AVDoa08009. Epub 2008 Sep 25.

Abstract

BACKGROUND

The Walking Impairment Questionnaire (WIQ) measures walking ability in daily life in patients with peripheral arterial disease causing intermittent claudication. We investigated the efficacy of sarpogrelate, a 5-HT2A receptor antagonist, in improving walking ability, as measured using new Japanese version of the WIQ.

PATIENTS AND METHODS

A nationwide multicenter study was conducted at 80 institutions in Japan involving 586 patients with stable symptoms of intermittent claudication. Patients received open-label sarpogrelate 300 mg/day. A total of 419 patients were evaluated in the full analysis set (FAS) following the intention to treat principle, and 354 patients were evaluated in the per-protocol set (PPS). The FAS data are emphasized here.

RESULTS

The mean follow-up was 27.7 ± 10.1 weeks. Each subscale of the WIQ score showed improvement after sarpogrelate treatment (p < 0.0001), and the resting ankle-brachial index increased significantly (p < 0.0001). The incidence of adverse reactions of the entire series of 559 patients was 4.83% (27 patients), but there were no clinically significant safety concerns.

CONCLUSIONS

We have for the first time demonstrated that sarpogrelate may improve walking ability in daily life in Japanese patients with intermittent claudication. The drug had a good safety profile.

摘要

背景

步行障碍问卷(WIQ)用于测量因外周动脉疾病导致间歇性跛行患者的日常生活步行能力。我们使用新版日本版WIQ,研究了5-HT2A受体拮抗剂沙格雷酯在改善步行能力方面的疗效。

患者与方法

在日本80家机构开展了一项全国性多中心研究,纳入586例间歇性跛行症状稳定的患者。患者接受开放标签的沙格雷酯,每日300 mg。按照意向性分析原则,共有419例患者纳入全分析集(FAS)进行评估,354例患者纳入符合方案集(PPS)进行评估。此处重点介绍FAS数据。

结果

平均随访时间为27.7±10.1周。沙格雷酯治疗后,WIQ评分的各子量表均有改善(p<0.0001),静息踝臂指数显著升高(p<0.0001)。559例患者的不良反应发生率为4.83%(27例),但无临床显著的安全性问题。

结论

我们首次证明,沙格雷酯可能改善日本间歇性跛行患者的日常生活步行能力。该药物安全性良好。

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