A systematic review 1 including 11 studies with a total of 2,131 subjects was abstracted in DARE. Cilostazol had a significantly greater effect than placebo on both the mean walking distance (MWD) (WMD +52.19 m, 95% CI: 32.08 to 72.31; 5 RCTs) and pain-free walking distance (PFWD) (WMD +39.75 m, 95% CI: 23.39 to 56.10; 3 RCTs). Similar smaller, but still statistically significant, effects were seen 4 weeks into treatment (3 RCTs). PGE1 had a significantly greater effect than placebo on both the MWD (WMD +100.27 m, 95% CI: 15.76 to 184.78; 3 RCTs) and PFWD (WMD +55.73 m, 95% CI: 21.54 to 89.92; 3 RCTs). The results were similar when the analysis was at 4 weeks. One RCT on beraprost reported no statistically significant changes in MWD and PFWD after 12 weeks. Adverse effects that were more common in those taking cilostazol included headache, dizziness, palpitation, diarrhoea and abnormal stool.
Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies).
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