Therapy for Peripheral Artery Disease: Gaps in Treating Patients With Claudication

Abstract

Peripheral artery disease (PAD) is estimated to affect up to 29% of people ≥50 years of age in the US¹ and over 200 million people worldwide.² Diagnosis of PAD is associated with an increased risk of adverse medical events and premature mortality from cardiovascular disease.^3,4 The classic symptom of PAD, intermittent claudication (IC), is characterized by exertional leg pain that resolves with rest and is estimated to affect up to 35% of PAD patients 50 years of age and older.^5,6 Patients with PAD and IC have impaired walking ability and poor functional outcomes as well as a reduced quality of life due at least in part to the leg pain experienced.⁷ Thus, PAD with IC is a significant international healthcare concern with adverse impact on patients resulting from the systemic atherosclerosis and the symptom of IC. There are few pharmacological therapy options available to treat PAD symptoms. The most efficacious option currently to improve IC is supervised walking exercise. However, this treatment is not widely available despite the strong evidence of its efficacy. In contrast, options that are more readily available to provide symptom relief for IC include invasive treatments such as endovascular therapy and surgical procedures.⁸