Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: In discussing medical treatment of PAD, Dr Hankey and colleagues1 state that “a meta-analysis of 8 [randomized controlled trials] involving 2702 patients demonstrated that cilostazol improved maximum walking distance and pain-free walking distance,” citing Thompson et al.2 However, in that study, the effect size was small, with increases of 50% and 67% in maximum walking distance and pain-free walking distance, respectively. Stated differently, if a patient could walk to first base before experiencing claudication, then with the addition of cilostazol, with its potential toxicity and at a cost in our pharmacy of $467.78 per month, he or she could round first and make it part of the way to second base.
Finucane TE. Medical Management of Peripheral Arterial Disease. JAMA. 2006;296(1):41-42. doi:10.1001/jama.296.1.41-b