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P6.10 Propionyl-L-Carnitine for Intermittent Claudication. A Cochrane Review


Intermittent claudication (IC) is a symptomatic form of peripheral arterial disease (PAD) (pain in the lower limbs with walking and relieved by rest). Propionyl-L-carnitine (PLC) is a drug which may lower the symptoms of PAD. Is PLC efficacious in improving clinical outcomes in IC patients?

For this Cochrane review randomized controlled trials in patients with IC receiving PLC compared with placebo or other intervention were selected. Pain-free and maximal walking performance were analyzed by standardized exercise test. ABI, quality of life and adverse events were assessed. 13 Studies were included in this review (1423 patients). The results of the selected trials were brought together in patient pools. For the maximal walking distance, the mean difference in walking performance after use of PLC compared to placebo was an absolute increase of 50.86 m (95% CI 50.34 to 51.38) or a 26% relative improvement (23 to 28%). For the pain-free walking distance, the improvement in walking performance with PLC compared to placebo was an absolute increase of 32.98 m (32.60 to 33.37) or a 31 % relative improvement (28 to 34%) . PLCs had an 0.09 (0.08 to 0.09) improvement in ABI over placebo. The adverse events of PLC were similar as in the control group and PLC seemed well tolerated and safe. PLC 1–2g a day costs 0.30 to 0.70 €.

PLC for IC shows a significant, though mild to moderate improvement of walking distances and ABI compared to placebo. The safety of PLC is comparable to placebo. In practice, PLC could be useful adjuvant to classic IC-therapies or when these are contra-indicated, not feasible or ineffective. This work is a Cochrane review. The data presented here presented are provisional (as the review has not yet been published).

The citation for the Cochrane protocol is: de Backer TLM, Campens L, Vander Stichele R, Van Bortel L, De Bacquer D. Propionyl-L-carnitine for intermittent claudication (Protocol). Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD010117. DOI: 10.1002/14651858.CD010117.

The authors acknowledge the Cochrane Peripheral Vascular Diseases Group.

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De Backer, T., Kamoen, V., Stichele, R.V. et al. P6.10 Propionyl-L-Carnitine for Intermittent Claudication. A Cochrane Review. Artery Res 8, 148 (2014).

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