beraprost and sarpogrelate

It is often difficult to compare the characteristics of a medicine with those of others based on common standards, whereas the application of rational standards would be expected to facilitate the comparison of medicines with similar effects. The present study was conducted to clarify the characteristics of individual medicines and to examine whether rational standards allow the most appropriate medicines to be chosen.. Participants diagnosed with lumbar spinal stenosis (LSS) were assessed for QOL and ADL based on the Roland-Morris Disability Questionnaire, JOA score, VAS, and the presence of intermittent claudication (IC). Four medicines--beraprost sodium, ethyl icosapentate (EPA), sarpogrelate hydrochloride, and limaprost alfadex (PGE1)--were prescribed in a random manner. These four medicines were assessed independently in four studies using the same study design and size in each case. Using the NMatrix, the characteristics of the four medicines and the results of mutual comparisons could be displayed concisely and clearly in one matrix based on significance levels. This work involved analyzing pooled data from the four studies.. All four medicines improved IC--one of the characteristic symptoms of LSS--by 12 weeks after administration. PGE1 required more time than the other medicines to affect IC. EPA appeared to almost significantly ameliorate some items at every point, though the evidence was insufficient.. The NMatrix concisely and clearly displays the characteristics of "medicines with similar effects" for the treatment of lumbar spinal stenosis, and can help physicians to choose the optimal medicine based on rational criteria for individual patients, according to their symptoms and progress.

Topics: Aged; Aged, 80 and over; alpha-Cyclodextrins; Alprostadil; Decision Making; Eicosapentaenoic Acid; Epoprostenol; Female; Humans; Lumbar Vertebrae; Male; Middle Aged; Pain Measurement; Platelet Aggregation Inhibitors; Sciatica; Spinal Stenosis; Succinates; Treatment Outcome

The effect of the prostaglandin I2 analog, beraprost sodium (BPS), on hemodialysis (HD) patients with peripheral arterial disease (PAD) has not been fully elucidated. The effect of BPS was compared to that of PAD drugs in HD patients with PAD in a multicenter randomized prospective interventional pilot study (J-PADD). Seventy-two PAD patients on HD were entered and randomly divided into two groups; that is, BPS group (Group A: n = 35) and PAD drug (cilostazol or sarpogrelate) group (Group B: n = 37). Primary endpoint was changes in skin perfusion pressure (SPP). Kidney Disease Quality of Life (KDQOL) score, cardiovascular events, PAD events, and adverse events were also evaluated. SPP increased significantly in both groups at 24 weeks from their basal levels. The absolute increase of SPP in Group A and Group B were 15.4 ± 30.0 mm Hg (P < 0.0001) and 20.2 ± 22.1 mm Hg (P = 0.025) (instep), and 13.8 ± 19.3 mm Hg (P < 0.0001) and 9.2 ± 16.3 mm Hg (P = 0.041) (sole), respectively. Changes of KDQOL score showed significantly better result in the role of physical score in Group A compared with Group B. Although heart rate was unchanged in Group A, 9.3/min increase was seen in Group B patients who received cilostazol. There was no intergroup difference in cardiovascular events and/or PAD events between the two groups during the study period. This exploratory pilot study suggested BPS was as effective as anti-platelet drugs in improving microcirculation in HD patients.

Topics: Aged; Aged, 80 and over; Cilostazol; Epoprostenol; Female; Heart Rate; Humans; Male; Microcirculation; Middle Aged; Peripheral Arterial Disease; Pilot Projects; Platelet Aggregation Inhibitors; Prospective Studies; Quality of Life; Renal Dialysis; Succinates; Tetrazoles; Treatment Outcome

This open-label prospective study compared the antiplatelet potency of sarpogrelate, aspirin, and beraprost in 20 healthy volunteers according to in-vitro closure time. Volunteers were assigned to receive sarpogrelate, aspirin, or beraprost for 14 days, then given 14 days of washout, then switched to another of these medications. We measured in-vitro closure time using a platelet function analyzer with collagen/epinephrine (CEPI). We also measured bleeding time, von Willebrand factor (vWF), D-dimer, high sensitivity C-reactive protein (hs-CRP), and fibrinogen. Baseline parameters were normal in all individuals and were not significantly different among the three groups. In patients who received sarpogrelate, there was no difference in CEPI-closure time at baseline and after 14 days. Aspirin and beraprost significantly prolonged the day 14 CEPI-closure time compared with baseline, from 145 +/- 37 to 259 +/- 41 s (P < 0.0001) and from 134 +/- 37 to 150 +/- 27 s (P = 0.035), respectively. The CEPI-closure time change was greater for aspirin than for beraprost (178 +/- 28 vs. 112 +/- 20%, P < 0.0001). None of the drugs changed the bleeding times of levels of vWF, D-dimer, hs-CRP, and fibrinogen. In conclusion, ingestion of aspirin (100 mg daily) and beraprost (120 microg daily) for 14 days significantly prolonged in-vitro closure time but ingestion of saprogrelate (300 mg daily) for 14 days did not. Aspirin was superior to beraprost in antiplatelet potency, as assessed by in-vitro closure time with CEPI.

Topics: Adult; Aspirin; Epoprostenol; Female; Humans; Male; Platelet Aggregation Inhibitors; Platelet Function Tests; Prospective Studies; Succinates

We report a 16-year-old man with severe heart failure due to idiopathic pulmonary arterial hypertension (IPAH). The patient was initially treated with a combination of beraprost, a prostacyclin analog, and sarpogrelate, a serotonin receptor inhibitor. However, he was unresponsive to the treatment. We then changed the treatment to sildenafil, and his condition dramatically improved. Sildenafil has an immediate pulmonary vasodilator effect in patients already receiving vasodilators for IPAH.

Topics: Adolescent; Drug Therapy, Combination; Epoprostenol; Humans; Hypertension, Pulmonary; Male; Piperazines; Purines; Serotonin Antagonists; Sildenafil Citrate; Succinates; Sulfones; Treatment Outcome; Vasodilator Agents