Patients with intermittent claudication may see most improvement through a supervised exercise program, either alone or with endovascular revascularisation, Queensland researchers say.

But none of the four therapeutic approaches compared in the network meta-analysis was durable beyond two years, they report in the Journal of the American Heart Association.

Their aim was to help resolve controversy over the best treatments for the condition, which had arisen due to a lack of head-to-head studies.

They found 46 studies, including more than 4250 patients, for the systematic review of randomised controlled trials that compared placebo with either home exercise therapy, supervised exercise therapy, endovascular revascularisation, treatment with cilostazol or any combination of these.