Condition

Lower extremity peripheral arterial disease

Clinical trials and treatment information for Lower extremity peripheral arterial disease

113.7M
People Affected
80
Active Trials
3.4M
New Cases/Year
68K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Endovascular Revascularization (Angioplasty/Stenting)
85% Effectiveness• 90% Confidence• 62% Safety• 3 trials• 75K participants
MODERATE EvidenceGood ValueDose: N/A
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Comparative Safety Scale(Higher is safer)

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62
DangerousModerateSafe

Time to Effect

Immediate to days

Duration

Single procedure, ongoing monitoring/potential re-interventions

Response Rate

80%

Remission Rate

70%

Common Side Effects:

Access site complications (hematoma, pseudoaneurysm): 8%
Vessel dissection: 5%
Restenosis/Re-occlusion (requiring re-intervention): 25%
Contrast-induced nephropathy: 2%

Annual Cost of Care

Drug Cost

$0

Monitoring

$500

Side Effects

$200

Total Annual

$5,000

Cost-Effectiveness

GOOD

QALYs Gained

0.35

ICER

$85,000/QALY

Cost per Remission

$7,143

Cost per Responder

$6,250

Treatment Outcomes
Primary Outcomes
Ankle-Brachial Index (ABI)0.65
+38.5% (+0.25)
Pain-Free Walking Distance (PFWD)100 meters
+150% (+150 meters)
Toe-Brachial Index (TBI)0.30
+93.3% (+0.28)
Rutherford Classification Score3.5 / 6
-51.4% (-1.8 points)
Secondary Benefits
VascuQol Score4.0 / 7
+30% (+1.2 points)
6-Minute Walk Test (6MWT) Distance250 meters
+34% (+85 meters)
Pain Severity (VAS Scale)6 / 10
-66.7% (-4 points)
Common Side Effects
Access site complications (hematoma, pseudoaneurysm)
+8%
Vessel dissection
+5%
Restenosis/Re-occlusion (requiring re-intervention)
+25%
2
Surgical Revascularization (Bypass Surgery)
88% Effectiveness• 85% Confidence• 55% Safety• 9 trials• 30K participants
MODERATE EvidenceGood ValueDose: N/A
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Comparative Safety Scale(Higher is safer)

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55
DangerousModerateSafe

Time to Effect

Immediate to weeks

Duration

Single procedure, ongoing monitoring/potential re-interventions

Response Rate

85%

Remission Rate

75%

Common Side Effects:

Surgical site infection: 10%
Bleeding/Hematoma: 8%
Graft thrombosis/failure: 20%
Cardiac complications (MI, arrhythmia): 7%
Stroke: 3%
Mortality: 2%

Annual Cost of Care

Drug Cost

$0

Monitoring

$500

Side Effects

$500

Total Annual

$6,000

Cost-Effectiveness

GOOD

QALYs Gained

0.45

ICER

$95,000/QALY

Cost per Remission

$8,000

Cost per Responder

$7,059

Treatment Outcomes
Primary Outcomes
Ankle-Brachial Index (ABI)0.60
+50% (+0.30)
Rest Pain Severity (NRS 0-10)7/10
-71.4% (-5 points)
Toe Pressure25 mmHg
+140% (+35 mmHg)
Maximum Claudication-Free Walking Distance100 meters
+200% (+200 meters)
Secondary Benefits
Quality of Life (EQ-5D-5L Utility Score)0.60
+25% (+0.15)
Wound Surface Area10 cm^2
-80% (-8 cm^2)
Physical Function (SF-36 PCS Score)30 points
+50% (+15 points)
Common Side Effects
Surgical site infection
+10%
Bleeding/Hematoma
+8%
Graft thrombosis/failure
+20%
3
Supervised Exercise Therapy (SET)
75% Effectiveness• 92% Confidence• 95% Safety• 150 trials• 15K participants
HIGH EvidenceExcellent ValueDose: 30-60 minutes, 3 times per week
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Comparative Safety Scale(Higher is safer)

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95
DangerousModerateSafe

Time to Effect

3-6 months

Duration

Ongoing (typically 3-6 months structured program, then maintenance)

Response Rate

70%

Remission Rate

50%

Number Needed to Treat (NNT)

5

Common Side Effects:

Muscle soreness: 30%
Fatigue: 20%
Minor musculoskeletal injury: 5%

Annual Cost of Care

Drug Cost

$0

Monitoring

$500

Side Effects

$0

Total Annual

$500

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.1

ICER

$8,000/QALY

Cost per Remission

$4,000

Cost per Responder

$2,857

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+75%
Response Rate
+70%
Remission Rate
+50%
Common Side Effects
Muscle soreness
+30%
Fatigue
+20%
Minor musculoskeletal injury
+5%
4
Cilostazol
65% Effectiveness• 88% Confidence• 70% Safety• 4 trials• 12K participants
HIGH EvidenceModerate ValueDose: 100mg twice daily
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Comparative Safety Scale(Higher is safer)

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70
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

Long-term, as needed

Response Rate

60%

Remission Rate

40%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

15

Common Side Effects:

Headache: 25%
Diarrhea: 15%
Palpitations/Tachycardia: 10%
Dizziness: 10%

Annual Cost of Care

Drug Cost

$500

Monitoring

$50

Side Effects

$100

Total Annual

$650

Cost-Effectiveness

MODERATE

QALYs Gained

0.06

ICER

$90,000/QALY

Cost per Remission

$1,625

Cost per Responder

$1,083

Treatment Outcomes
Primary Outcomes
Pain-Free Walking Distance (PFWD)150 meters
+40% (+60 meters)
Maximum Walking Distance (MWD)300 meters
+25% (+75 meters)
Walking Impairment Questionnaire (WIQ) - Pain ScoreWIQ Pain Score: 40/100
-15% (-6 points)
Secondary Benefits
Walking Impairment Questionnaire (WIQ) - Distance ScoreWIQ Distance Score: 35/100
+20% (+7 points)
Ankle-Brachial Index (ABI)0.7 units
+7.1% (+0.05 units)
SF-36 Physical Functioning ScoreSF-36 Physical Functioning Score: 50/100
+10% (+5 points)
Common Side Effects
Headache
+25%
Diarrhea
+15%
Palpitations/Tachycardia
+10%

Clinical Trial Phases:

Phase 3Phase 4
5
Atorvastatin (Statin Therapy)
60% Effectiveness• 95% Confidence• 65% Safety• 1 trials• 500K participants
HIGH EvidenceExcellent ValueDose: 10-80mg daily
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Comparative Safety Scale(Higher is safer)

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65
DangerousModerateSafe

Time to Effect

Months for clinical benefits (CV event reduction)

Duration

Lifetime

Response Rate

80%

Remission Rate

%

Number Needed to Treat (NNT)

15

Number Needed to Harm (NNH)

1000

Common Side Effects:

Myalgia (muscle pain): 5%
Elevated liver enzymes: 2%
Rhabdomyolysis (rare): 0.01%

Annual Cost of Care

Drug Cost

$50

Monitoring

$100

Side Effects

$50

Total Annual

$200

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.25

ICER

$8,000/QALY

Cost per Responder

$250

Treatment Outcomes
Primary Outcomes
LDL Cholesterol130 mg/dL
-45% (-58.5 mg/dL)
Pain-Free Walking Distance150 meters
+20% (+30 meters)
Ankle-Brachial Index (ABI)0.75
+4% (+0.03)
Maximum Walking Distance300 meters
+18% (+54 meters)
Secondary Benefits
hs-CRP3.5 mg/L
-25% (-0.88 mg/L)
Total Cholesterol210 mg/dL
-30% (-63 mg/dL)
HDL Cholesterol40 mg/dL
+8% (+3.2 mg/dL)
Common Side Effects
Myalgia (muscle pain)
+5%
Elevated liver enzymes
+2%
Rhabdomyolysis (rare)
+0.01%

Clinical Trial Phases:

Phase 4
6
Clopidogrel
55% Effectiveness• 92% Confidence• 72% Safety• 8 trials• 150K participants
HIGH EvidenceExcellent ValueDose: 75mg daily
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Comparative Safety Scale(Higher is safer)

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72
DangerousModerateSafe

Time to Effect

Days for antiplatelet effect, long-term for CV event reduction

Duration

Lifetime

Response Rate

70%

Remission Rate

%

Number Needed to Treat (NNT)

40

Number Needed to Harm (NNH)

100

Common Side Effects:

Bleeding (non-major): 5%
Major bleeding (e.g., GI hemorrhage): 1%
Dyspepsia: 3%

Annual Cost of Care

Drug Cost

$100

Monitoring

$500

Side Effects

$100

Total Annual

$700

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$20,000/QALY

Cost per Responder

$286

Treatment Outcomes
Primary Outcomes
Major Adverse Cardiovascular Events (MACE) RiskAnnual risk: 10.0%
-17% (-1.7% Absolute Risk Reduction)
Major Adverse Limb Events (MALE) RiskAnnual risk: 6.0%
-15% (-0.9% Absolute Risk Reduction)
Non-fatal Stroke IncidenceAnnual incidence: 3.0%
-20% (-0.6% Absolute Risk Reduction)
Cardiovascular MortalityAnnual mortality: 4.0%
-10% (-0.4% Absolute Risk Reduction)
Secondary Benefits
Walking Impairment Questionnaire (WIQ) Pain Score45/100 (higher score indicates less pain/impairment)
+5% (+2.25 points)
Ankle-Brachial Index (ABI)0.68
+2% (+0.014)
Total Walking Distance (Treadmill)300 meters
+8% (+24 meters)
Common Side Effects
Bleeding (non-major)
+5%
Major bleeding (e.g., GI hemorrhage)
+1%
Dyspepsia
+3%

Clinical Trial Phases:

Phase 3Phase 4
7
Aspirin
50% Effectiveness• 95% Confidence• 80% Safety• 13 trials• 200K participants
HIGH EvidenceExcellent ValueDose: 75-325mg daily (typically 81mg or 100mg)
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Comparative Safety Scale(Higher is safer)

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80
DangerousModerateSafe

Time to Effect

Immediate for antiplatelet effect, long-term for CV event reduction

Duration

Lifetime

Response Rate

65%

Remission Rate

%

Number Needed to Treat (NNT)

50

Number Needed to Harm (NNH)

200

Common Side Effects:

Gastrointestinal bleeding: 3%
Dyspepsia: 8%
Hemorrhagic stroke (rare): 0.1%

Annual Cost of Care

Drug Cost

$20

Monitoring

$500

Side Effects

$50

Total Annual

$570

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.15

ICER

$5,000/QALY

Cost per Responder

$108

Treatment Outcomes
Primary Outcomes
Major Adverse Cardiovascular Events (MACE)5.0% annual event rate (cardiovascular death, nonfatal MI, nonfatal stroke)
-22% (-1.1% annual event rate reduction)
Major Adverse Limb Events (MALE)3.0% annual event rate (acute limb ischemia, major amputation, revascularization for critical limb ischemia)
-20% (-0.6% annual event rate reduction)
Non-fatal Myocardial Infarction2.0% annual event rate
-18% (-0.36% annual event rate reduction)
Non-fatal Ischemic Stroke1.5% annual event rate
-10% (-0.15% annual event rate reduction)
Secondary Benefits
All-cause Mortality4.0% annual mortality rate
-5% (-0.2% annual mortality rate reduction)
Incidence of Major Bleeding Events1.0% annual incidence
+50% (+0.5% annual incidence increase)
Common Side Effects
Gastrointestinal bleeding
+3%
Dyspepsia
+8%
Hemorrhagic stroke (rare)
+0.1%

Clinical Trial Phases:

Phase 4