THERAPEUTICAL NOTES   

Minerva Medica 2001 February;92(1):61-8

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

Treatment of chronic arterial occlusive disease of the lower limbs with propionyl-1-carnitine in elderly patients

Terranova R., Luca S.

Background. Atherosclerosis is the most common pathology affecting the arterial system in elderly patients and arterial occlusive disease of the lower limbs represents one of the most severe complications. Intermittent claudication is the clinical expression of the ischemia underlying this arterial disease. Patients suffering from this complication present altered homeostasis of carnitine that results, by means of various mechanisms, in an alteration of the oxidative processes and damages the oxidative phosphorylation of the skeletal muscle. The effects of treatment with propionyl-l-carnitine (PLC) in a group of elderly patients with intermittent claudication (IC) are studied.
Methods. 39 elderly patients with IC were enrolled in an open study. The diagnosis was made using arterial colour ultrasonography of the lower limbs and patients were asked to perform the treadmill test. All patients received 300 mg i.v. PLC a day for 2 weeks and 1 g twice a day per os for 18 weeks. Patients presenting heart, respiratory or other problems restricting physical exercise were excluded from the study. Results. After 5 months of treatment an improvement was obtained in the distance after which IC appeared (from 213±8 m to 357±13 m) and the maximum distance covered (from 307±12 m to 549±23 m).
Conclusions. The results of this study allowed us to evaluate the efficacy of this drug on the severely disabling pain affecting the quality of life of patients, thus enabling the maximum distance covered by these patients to be increased. Moreover, the drug was well tolerated (only two patients reported slight collateral effects ascribed to the drug) and safe to use. It represents a valid conservative, non-surgical treatment which can be administered to all patients with intermittent claudication.