Increasing 6-Minute Walking Distance in Peripheral Artery Disease

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No significant improvement in 6MWD was noted in the exercise plus GM-CSF vs exercise alone groups.
No significant improvement in 6MWD was noted in the exercise plus GM-CSF vs exercise alone groups.

HealthDay News — Supervised treadmill exercise, but not granulocyte-macrophage colony-stimulating factor (GM-CSF), improves 6-minute walking distance among patients with peripheral artery disease (PAD), according to a study published online in the Journal of the American Medical Association to coincide with the American Heart Association's Scientific Sessions, held Nov. 11 to 15 in Anaheim, California.

Mary M. McDermott, MD, from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues randomized patients with PAD to receive supervised exercise + GM-CSF (exercise + GM-CSF; 53 participants), supervised exercise + placebo (exercise alone; 53 participants), attention control + GM-CSF (GM-CSF alone; 53 participants), and attention control + placebo (51 participants).

The researchers found that there was no significant improvement in the six-minute walk distance for exercise + GM-CSF versus exercise alone (mean difference, -6.3 m [95% CI, -30.2 to +17.6]; P =.61) or versus GM-CSF alone (mean difference, +28.7 m [95 percent confidence interval, +5.1 to +52.3]; Hochberg-adjusted P = 0.052) at 12-week follow-up. Compared with attention control + placebo, GM-CSF alone did not improve 6-minute walk (mean difference, -1.4 m [95% CI, -25.2 to +22.4]; P =.91), while exercise alone did improve 6-minute walk significantly (mean difference, + 33.6 m [95% CI, +9,4 to + 57.7]; Hochberg-adjusted P =.02).

"These results confirm the benefits of exercise but do not support using GM-CSF to treat walking impairment in patients with PAD," the authors write.

Disclosures: Several authors disclosed ties to the biopharmaceutical industry.


McDermott MM, Ferrucci L, Tian L, et al. Effect of granulocyte-macrophage colony-stimulating factor with or without supervised exercise on walking performance in patients with peripheral artery disease. The PROPEL randomized clinical trial [published online November 15, 2017]. JAMA. doi:10.1001/jama.2017.17437

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