Lehert P, Comte S, Gamand S, Brown T M
Department of Computer Science and Statistics, Faculte Universitaire de Mons, Belgium.
J Cardiovasc Pharmacol. 1994;23 Suppl 3:S48-52.
A retrospective analysis was performed on all five published clinical trials in which naftidrofuryl was given at a dosage of 600 mg daily. Two studies were undertaken in France, two in Germany, and one in Great Britain. Data for the analysis, which included the presence of risk factors, treadmill walking distances, and cardiovascular critical events that occurred during the course of the study, were generated from the patients' original study file. Included in the analysis were 888 patients, 447 receiving naftidrofuryl and 441 receiving placebo. Although there were significant differences between the studies with regard to certain variables, distribution was comparable between the treatment groups justifying an analysis on the pooled sample. An intention-to-treat analysis based on a success/failure outcome was in favor of active treatment (p = 0.003) as was an analysis of change in pain-free walking distance (PFWD) (p < 0.002). None of the risk factors had any significant influence on change in PFWD. A further analysis indicated that there were significantly fewer cardiovascular critical events in the naftidrofuryl group than in the placebo group (p = 0.029). Because the incidence of cardiovascular critical events was lower in those patients who showed the greatest improvement in PFWD, and as surgical intervention was the most frequently encountered critical event, it is possible that treatment with naftidrofuryl may lead to a reduction or postponement of surgery. Such a finding would have implications for health-care resources.
对五项已发表的临床试验进行了回顾性分析,这些试验中萘呋胺酯的给药剂量均为每日600毫克。两项研究在法国开展,两项在德国开展,一项在英国开展。分析数据包括风险因素的存在情况、跑步机行走距离以及研究过程中发生的心血管严重事件,这些数据来自患者的原始研究档案。分析纳入了888名患者,其中447名接受萘呋胺酯治疗,441名接受安慰剂治疗。尽管各研究在某些变量方面存在显著差异,但治疗组之间的分布具有可比性,因此有理由对合并样本进行分析。基于成功/失败结果的意向性分析支持积极治疗(p = 0.003),无痛行走距离(PFWD)变化分析也支持积极治疗(p < 0.002)。没有任何风险因素对PFWD的变化有显著影响。进一步分析表明,萘呋胺酯组的心血管严重事件明显少于安慰剂组(p = 0.029)。由于在PFWD改善最大的患者中,心血管严重事件的发生率较低,而且手术干预是最常遇到的严重事件,因此萘呋胺酯治疗可能会导致手术减少或推迟。这一发现可能会对医疗资源产生影响。