RT Book, Section A1 Walsh, Michael A1 Perkovic, Vlado A1 Manns, Braden A1 Srinathan, Sadeesh A1 Meade, Maureen O. A1 Devereaux, PJ A1 Guyatt, Gordon A2 Guyatt, Gordon A2 Rennie, Drummond A2 Meade, Maureen O. A2 Cook, Deborah J. SR Print(0) ID 1193374388 T1 Therapy (Randomized Trials) T2 Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 978-0-07-179071-0 LK jamaevidence.mhmedical.com/content.aspx?aid=1193374388 RD 2024/10/09 AB CLINICAL SCENARIOA Patient With Peripheral Artery Disease: How Can I Improve Physical Function and Walking?You are a general internist following up a 62-year-old man with a history of type 2 diabetes mellitus, hypertension, and hyperlipidemia who is taking oral hypoglycemics, a statin, and a thiazide-like diuretic. A vascular surgeon recently evaluated the patient for intermittent claudication and made a diagnosis of peripheral artery disease. The surgeon prescribed low-dose aspirin and pentoxifylline to reduce the patient's risk of vascular events and improve his ability to walk, citing 2 systematic reviews: a review of antiplatelet agents in peripheral artery disease that found a decrease in the odds of vascular events (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.63-0.96) and an increase in walking distance of 59 m (95% CI, 37-81 m) and another review of pentoxifylline in peripheral artery disease that increased maximum walking distance by 59 m (95% CI, 37-81 m).1,2 Despite the new treatments, the patient is unable to walk more than 2 minutes without pain and finds his quality of life substantially impaired.Listening to the patient's story of poor response to treatment and ongoing symptoms, you recall seeing an article that may be relevant. You ask him to return in a week for further review of his medications.