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Pentoxifylline (Trental), a xanthine analog, was evaluated for tolerance, safety and efficacy in the treatment of chronic arterial disease in a pilot study. Evaluation was performed in 35 cases. Twenty patients (Fontaine stage II or stage III severity) were given pentoxifylline in a daily dose of 1200 mg (Trental 400 t.i.d.) and 15 patients were given placebo for a period of eight weeks, respectively. Pentoxifylline was significantly more effective than the placebo in increasing both the initial and absolute claudication distance (ICD and ACD) in patients with peripheral chronic occlusive arterial disease (COAD). The subjective parameters such as paresthesias, muscular cramps and sensation of heaviness in the legs paralled the course of walking parameters. These results support the hypothesis that pentoxifylline in doses of 400 mg (slow release tablets) t.i.d. enhances blood flow via reducing blood viscosity and improving red cell flexibility in patients with intermittent claudication due to COAD. Pentoxifylline is thus regarded as a promising drug for the treatment of circulatory ischemic disorders, especially in intermittent claudication. It was well tolerated with minimal untoward effects.
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