Pentoxifylline Therapy Research Articles

Pentoxifylline (Trental) Therapy for the Vasculitis of Atrophie Blanche

<h3>To the Editor.—</h3> Pentoxifylline (Trental) has been used worldwide since 1972 for the treatment of intermittent claudication. In 1984, the US Food and Drug Administration approved the release of this medication for use in the United States. This drug lowers the blood viscosity and improves erythrocyte flexibility. These effects allow increased blood flow to ischemic tissues. In November 1984, a 46-year-old man who had severe atrophie blanche with leukocytoclastic vasculitis for five years brought me a newspaper clipping about pentoxifylline therapy. His problem had been studied and a biopsy performed. The condition was only partially controlled with the administration of oral prednisone. The disease resulted in a multitude of small painful ulcers with crusts and scaling that extended from the foot almost to his knees. Pentoxifylline therapy was begun with a dosage of 400 mg twice a day for three days, then the dosage was changed to three tablets per

Purpura Necrotica: A Possible Clinical Application of the Shwartzman Phenomenon

ABSTRACT. It was hypothesized that pentoxifylline might improve the response to recombinant human erythropoietin (rh-Epo) in anemic renal failure patients. Sixteen patients with ESRD and rh-Epo-resistant anemia, defined by a hemoglobin of &lt;10.7 g/dl for 6 mo before treatment and a rh-Epo dose of ≥12,000 IU/wk, were recruited. They were treated with oral pentoxifylline 400 mg o.d. for 4 mo. <i>Ex vivo</i> T cell generation of tumor necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ) from the patients was assessed before treatment and 6 to 8 wk after therapy. A total of 12 of 16 patients completed the study. Before therapy, the 12 patients’ mean hemoglobin concentration was 9.5 ± 0.9 g/dl. After 4 mo of pentoxifylline treatment, the mean hemoglobin concentration increased to 11.7 ± 1.0 g/dl (<i>P</i> = 0.0001). Baseline <i>ex vivo</i> T cell expression of TNF-α decreased from 58% ± 11% to 31% ± 23% (<i>P</i> = 0.0007) after therapy. Likewise, IFN-γ expression decreased from 31% ± 10% to 13% ± 10% (<i>P</i> = 0.0002). Pentoxifylline therapy may significantly improve the hemoglobin response in patients with previously rh-Epo-resistant anemia in renal failure. This may occur due to inhibition of proinflammatory cytokine production, which could interfere with the effectiveness of rh-Epo.