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Daniel G Cacione

Daniel G Cacione

Federal University of São Paulo, Brazil

Title: Pharmacological treatment for Buerger’s disease – a Cochrane review

Biography

Daniel G Cacione is post graduate student at the Federal University of São Paulo and assistant medical doctor at São Paulo Hospital in Vascular & Endovascular Surgery. A Cochrane Collaboration  member since 2013, working with the Cochrane Vascular Group.
 

Abstract

Objective: To assess the effectiveness of any pharmacological agent (intravenous or oral) compared with placebo or any other pharmacological agent in patients with Buerger's disease

Methods: The Cochrane Vascular Trials Search Co-ordinator searched their Specialised Register (last searched in April 2015) and the Cochrane Register of Studies (Issue 3, 2015). The review authors searched trial registers and the European grey literature; screened reference lists of relevant studies, and contacted study authors and major pharmaceutical companies. Selection criteria was randomised controlled trials (RCTs) involving pharmacological agents used in the treatment of Buerger's disease.

Results: Five randomised controlled trials (total 602 participants) compared prostacyclin analogue with placebo, aspirin, or a prostaglandin analogue, and folic acid with placebo.

Conclusions Moderate quality evidence suggests that intravenous iloprost (prostacyclin analogue) is more effective than aspirin for eradicating rest pain and healing ischaemic ulcers in Buerger's disease, but oral iloprost is not more effective than placebo. Very low and low quality evidence suggests there is no difference between prostacyclin (iloprost and clinprost) and the prostaglandin analogue alprostadil for healing ulcers and relieving pain respectively in severe Buerger's disease. Very-low quality evidence suggests there is no difference in pain scores and amputation rates between folic acid and placebo, in people with Buerger's disease and hyperhomocysteinaemia. High quality trials assessing the effectiveness of pharmacological agents (intravenous or oral) in people with Buerger's disease are needed