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Efficacy and Safety of Fixed-Dose Combination Therapy with Cilostazol and Rosuvastatin in Patients with Symptomatic Lower Extremity Peripheral Artery Disease: A Multicenter Randomized Controlled Trial

A. Kemalasari, Dong-Woo Suh, I. Jin, Seung-Jun Lee, C. Ahn, Donghoon Choi, Ji-Yong Jang, C. Yu et al.

Cardiovascular Drugs and Therapy, 2026

260 participants · 1 citation

Abstract

PURPOSE

To evaluate whether combined cilostazol and rosuvastatin therapy improves health-related quality of life, walking performance, and lipid profiles compared with rosuvastatin alone in patients with symptomatic lower extremity peripheral artery disease (PAD).

METHODS

This multicenter, double-blind, randomized placebo-controlled trial enrolled 260 patients with chronic lower extremity PAD (Rutherford category 2 or 3) at 52 sites in Korea. Participants were randomly assigned (1:1) to receive cilostazol 200 mg plus rosuvastatin or a matching placebo plus rosuvastatin for 24 weeks. The primary endpoint was the change in the Korean Peripheral Artery Questionnaire (KPAQ) summary score from baseline to week 24.

RESULTS

A total of 257 patients were included in the full analysis set. The combination therapy group showed significantly greater improvement in the KPAQ summary score than in the rosuvastatin monotherapy group (least-squares mean change: 15.4 vs. 10.3 points; between-group difference 5.1 points, 95% confidence interval 1.5-8.7; P = 0.005). The treatment effect became statistically significant at week 12 and continued to increase through week 24. Treadmill walking distances improved in both groups; improvements were numerically greater with combination therapy but between-group differences were not significant at weeks 12 or 24. Compared with rosuvastatin monotherapy, combination therapy resulted in greater reductions in triglycerides and smaller increases in ApoB,…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 260 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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