Treatment of peripheral obstructive artery disease: a battle that could be winned also with drugs? [Trattamento dell'arteriopatia obliterante degli arti inferiori: Una battaglia che può essere vinta anche con i farmaci?]

The peripheral obstructive artery disease (POAD) epidemiology raises some concerns about its continuously increased incidence in Western countries. The most part of the patients affected by POAD have systemic cardiovascular complications and die because of cardiac and cerebrovascular disorders. Thus the social cost of this disease is very high. A large part of risk factors for the POAD is well-known and they are reversible trough an efficacious life-style improvement (mainly physical activity increase and cigarette smoking habit cessation) and cardiovascular disease risk factors control (diabetes mellitus, hypercholesterolemia, blood hypertension). On the contrary, no much data are available as it regards efficacious therapies for clinically active disease. The only ones that have been adequately investigated and already available in the market are cilostazol (maybe useful only in more serious patients), and sulodexide (that could improve the pain free walking distance till the 75%). Further research is needed in order to develop new efficacious drugs for POAD treatment, but in the meantime it is necessary to recognise all POAD patients as soon as possible and to treat them adequately with the available therapies.