Effects of the 5-HT2A Antagonist Sarpogrelate on Walking Ability in Patients with Intermittent Claudication as Measured Using the Walking Impairment Questionnaire

Background: The Walking Impairment Questionnaire (WIQ) measures walking ability in daily life in patients with peripheral arterial disease causing intermittent claudication. We investigated the efficacy of sarpogrelate, a 5-HT2A receptor antagonist, in improving walking ability, as measured using new Japanese version of the WIQ.

Patients and methods: A nationwide multicenter study was conducted at 80 institutions in Japan involving 586 patients with stable symptoms of intermittent claudication. Patients received open-label sarpogrelate 300 mg/day. A total of 419 patients were evaluated in the full analysis set (FAS) following the intention to treat principle, and 354 patients were evaluated in the per-protocol set (PPS). The FAS data are emphasized here.

Results: The mean follow-up was 27.7 ± 10.1 weeks. Each subscale of the WIQ score showed improvement after sarpogrelate treatment (p < 0.0001), and the resting ankle-brachial index increased significantly (p < 0.0001). The incidence of adverse reactions of the entire series of 559 patients was 4.83% (27 patients), but there were no clinically significant safety concerns.

Conclusions: We have for the first time demonstrated that sarpogrelate may improve walking ability in daily life in Japanese patients with intermittent claudication. The drug had a good safety profile.