DETRIMENTAL EFFECT OF HIGH-DOSE PROSTAGLANDIN-E1 IN THE TREATMENT OF ISCHEMIC ULCERS

  • 1 January 1983
    • journal article
    • research article
    • Vol. 93  (6) , 839-842
Abstract
Eight patients with ischemic lower extremity ulcers were entered into a randomized, controlled trial of i.v. prostaglandin E1 (PGE1) vs. placebo. All ulcers were stable or increasing in size for at least 3 wk prior to the study. Each patient had rest pain assessment, Doppler pressure measurements and ulcer measurements before and after infusion. Four patients received PGE1 and 4 received placebo. There were no significant preinfusion differences between groups. Rest pain remained stable or improved in all patients. In the placebo group, the mean absolute ankle pressure decreased 5 .+-. 14 mm Hg, but the mean ankle/arm pressure ratio increased 0.03 .+-. 0.06. In the PGE1 group, the mean absolute ankle pressure decreased 16 .+-. 16 mm Hg and the mean ankle/arm pressure ratio decreased 0.05 .+-. 0.06. Neither difference is statistically significant. Patients who received placebo had no change or decrease in ulcer size, but all patients who received PGE1 had an increase in ulcer size (P = 0.05, Wilcoxon rank sum test). One of the 4 placebo patients required extremity amputation during follow-up of 10.5 .+-. 3.5 mo. All 4 patients in the PGE1 group required amputation within 3.3 .+-. 2.6 mo. Despite theoretic benefits, i.v. PGE1 may be detrimental in the treatment of ischemic ulcers.

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