Peripheral artery disease (PAD) is a multifaceted disease that involves the arteries of the brain, visceral organs, and extremities. It is an atherosclerotic disorder that can lead to an increased risk of cardiovascular morbidity and mortality. In particular, PAD is known to cause lower extremity claudication, which is basically a condition that affects an individual’s ability to walk.
The study in this article examined the effect of ACE inhibitors on the walking capacities of patients with lower extremity PAD. This particular study conducted a systematic literature search that looked at 4 studies, which included randomized, double-blind, and placebo-controlled trials comparing the effectiveness of an ACE inhibitor with a placebo in patients with PAD. Researchers then used Comprehensive Meta Analysis to analyze the data of all the studies.
The results of this study were all over the place and a bit contradictory. There was a general trend among all of the studies that moved towards improving patients’ walking capacity, but some of the studies challenged this as well. Moreover, the results that demonstrated the effectiveness of ACE Inhibitors in treating claudication were from studies that only tested patients on treadmills and patients did not have any other conditions that may hinder their walking capacity. While the results for the usage of ACE inhibitors in treating claudication are inconclusive, current guidelines still recommend ACE inhibitors to be used for the cardioprotective effects in PAD.
I found this article to be interesting because we have been learning about the most common uses of Top Drugs in PoP and it’s easy to forget just how complex the mechanism of action of each drug is. There is so much research to be done in this field. A drug that has been commonly used for the past century may be able to treat another symptom or disease that no one has looked into yet. This article also emphasizes what we have been learning in Drug Development about the extent to which it takes for a drug to be developed and approved. Just as the multiple studies in this article showed, just because a drug shows efficacy or safety in a group of patients that does not mean that it is marketable. Extensive trials and studies should be undertaken to ensure the safety and efficacy of all drugs.
Barrons R, Woods A. The Role of ACE Inhibitors in Lower Extremity Peripheral Artery Disease. Am J Ther. 2016;23(1):7-15.