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Safety and Effectiveness of a Shortened Regimen of Alprostadil (PGE1) with Large Infusion Dose, for Ischemic Manifestations of the Extremities in Real-World Clinical Practice

Teresa Cervera, José Manuel Ligero, Ana de Lorenzo

Objective: To analyse historical indications, tolerance, secondary effects and effectiveness of a treatment regimen with short interrupted cycles of large doses of PGE1 as well as possible factors that may influence the results in real world clinical practice in a tertiary hospital.

Material and Methods: This is an observational, descriptive, retrospective study of all patients treated from 2013 to 2020 with high-doses of PGE1 in our hospital.

Results: Forty five patients from 27 to 91 years old were treated for ischemic diseases, grouped into 6 types. Treatment caused side effects in 14 patients (31%) and has to be discontinued in 6 of them for intolerance (13% of total). Intolerance was associated with heart disease and advanced age. No short or long term complications were observed in these patients after discontinuation of treatment. Effectiveness was considered in 53.3% in mean, decreasing with age, more abruptly from 80 years old. Neither heart disease nor kidney disease, decreased effectiveness.

Conclusion: Although side effects are relatively common, there is no morbidity associated with the high-dose in short cycles of alprostadil, with a considerable effectiveness in not elderly patients and thus, could be considered a useful tool in the treatment of severe non-surgical vascular pathology.