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Published in: Cardiology and Therapy 1/2018

Open Access 01-06-2018 | Original Research

Clinical Acceptability Of Trimetazidine Modified-Release 80 mg Once Daily Versus Trimetazidine Modified-Release 35 mg Twice Daily In Stable Angina Pectoris

Authors: Yuri M. Pozdnyakov, On behalf of the study investigators

Published in: Cardiology and Therapy | Issue 1/2018

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Abstract

Introduction

Trimetazidine (TMZ) is an anti-ischemic metabolic agent that has been shown to be efficacious in angina treatment, both in monotherapy and in combination. A new formulation of TMZ modified-release (MR) 80 mg was developed, which is to be taken once daily (od), instead of twice daily (bid) for the currently available TMZ MR 35 mg, with the aim of simplifying the medication regimen.

Methods

The present study was an international, multicenter, randomized, double-blind, parallel-group phase III study with a 12-week treatment period. The safety of TMZ MR 80 mg once daily was assessed compared to TMZ MR 35 mg twice daily, in patients previously treated successfully by the latter. Emergent adverse events (EAEs), biological parameters, vital signs, 12-lead resting ECG (electrocardiogram) and Canadian Cardiovascular Society (CCS) classification were recorded.

Results

One-hundred and sixty-five patients previously diagnosed with stable angina pectoris on treatment were randomized to receive either TMZ MR 80 mg od or TMZ MR 35 mg bid. In the TMZ MR 80 mg group, fewer patients had ≥ 1 EAE (17.1 vs. 22.9% in the TMZ MR 35 mg group). Serious EAEs were reported by three patients in each group. No EAE required dose modification, withdrawal, or temporary interruption of study treatments. Vital signs, 12-lead ECG, and laboratory parameters did not change. No worsening in CCS classes was observed with either treatment.

Conclusions

TMZ MR 80 mg od and TMZ MR 35 mg bid have similar safety profiles. This new once-daily formulation could improve patient compliance with therapy, thereby enhancing clinical benefit.

Trial Registration

ISRCTN registry, ISRCTN 84362208.

Funding

Institut de Recherches Internationales Servier and Servier, Moscow, Russian Federation.

Plain Language Summary

Plain language summary available for this article.
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Literature
1.
go back to reference Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96.CrossRefPubMed Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96.CrossRefPubMed
2.
go back to reference Beltrame JF, Weekes AJ, Morgan C, Tavella R, Spertus JA. The prevalence of weekly angina among patients with chronic stable angina in primary care practices: the Coronary Artery Disease in General Practice (CADENCE) Study. Arch Intern Med. 2009;169:1491–9.CrossRefPubMed Beltrame JF, Weekes AJ, Morgan C, Tavella R, Spertus JA. The prevalence of weekly angina among patients with chronic stable angina in primary care practices: the Coronary Artery Disease in General Practice (CADENCE) Study. Arch Intern Med. 2009;169:1491–9.CrossRefPubMed
3.
go back to reference Kureshi F, Shafiq A, Arnold SV, et al. The prevalence and management of angina among patients with chronic coronary artery disease across US outpatient cardiology practices: insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study. Clin Cardiol. 2017;40:6–10.CrossRefPubMed Kureshi F, Shafiq A, Arnold SV, et al. The prevalence and management of angina among patients with chronic coronary artery disease across US outpatient cardiology practices: insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study. Clin Cardiol. 2017;40:6–10.CrossRefPubMed
4.
go back to reference Qintar M, Spertus JA, Gosch KL, et al. Effect of angina under-recognition on treatment in outpatients with stable ischaemic heart disease. Eur Heart J Qual Care Clin Outcomes. 2016;2:208–14.CrossRefPubMedPubMedCentral Qintar M, Spertus JA, Gosch KL, et al. Effect of angina under-recognition on treatment in outpatients with stable ischaemic heart disease. Eur Heart J Qual Care Clin Outcomes. 2016;2:208–14.CrossRefPubMedPubMedCentral
5.
go back to reference Arnold SV, Morrow DA, Lei Y, et al. Economic impact of angina after an acute coronary syndrome: insights from the MERLIN-TIMI 36 trial. Circ Cardiovasc Qual Outcomes. 2009;2:344–53.CrossRefPubMed Arnold SV, Morrow DA, Lei Y, et al. Economic impact of angina after an acute coronary syndrome: insights from the MERLIN-TIMI 36 trial. Circ Cardiovasc Qual Outcomes. 2009;2:344–53.CrossRefPubMed
6.
go back to reference Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34:2949–3003.CrossRefPubMed Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34:2949–3003.CrossRefPubMed
7.
go back to reference Fragasso G, Perseghin G, De Cobelli F, et al. Effects of metabolic modulation by trimetazidine on left ventricular function and phosphocreatine/adenosine triphosphate ratio in patients with heart failure. Eur Heart J. 2006;27:942–8.CrossRefPubMed Fragasso G, Perseghin G, De Cobelli F, et al. Effects of metabolic modulation by trimetazidine on left ventricular function and phosphocreatine/adenosine triphosphate ratio in patients with heart failure. Eur Heart J. 2006;27:942–8.CrossRefPubMed
8.
go back to reference Danchin N, Marzilli M, Parkhomenko A, Ribeiro JP. Efficacy comparison of trimetazidine with therapeutic alternatives in stable angina pectoris: a network meta-analysis. Cardiology. 2011;120:59–72.CrossRefPubMed Danchin N, Marzilli M, Parkhomenko A, Ribeiro JP. Efficacy comparison of trimetazidine with therapeutic alternatives in stable angina pectoris: a network meta-analysis. Cardiology. 2011;120:59–72.CrossRefPubMed
9.
go back to reference Kardas P, On behalf of COMPASS investigators. Comparison of once daily versus twice daily oral nitrates in stable angina pectoris. Am J Cardiol. 2004;94:213–6.CrossRefPubMed Kardas P, On behalf of COMPASS investigators. Comparison of once daily versus twice daily oral nitrates in stable angina pectoris. Am J Cardiol. 2004;94:213–6.CrossRefPubMed
10.
go back to reference Spertus JA, Dewhurst T, Dougherty CM, Nichol P. Testing the effectiveness of converting patients to long-acting antianginal medications: the Quality of Life in Angina Research Trial (QUART). Am Heart J. 2001;141:550–8.CrossRefPubMed Spertus JA, Dewhurst T, Dougherty CM, Nichol P. Testing the effectiveness of converting patients to long-acting antianginal medications: the Quality of Life in Angina Research Trial (QUART). Am Heart J. 2001;141:550–8.CrossRefPubMed
11.
go back to reference Kardas P. Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial. Vasc Health Risk Manag. 2007;3:235–42.CrossRefPubMedPubMedCentral Kardas P. Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial. Vasc Health Risk Manag. 2007;3:235–42.CrossRefPubMedPubMedCentral
13.
go back to reference Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001;23:1296–310.CrossRefPubMed Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001;23:1296–310.CrossRefPubMed
Metadata
Title
Clinical Acceptability Of Trimetazidine Modified-Release 80 mg Once Daily Versus Trimetazidine Modified-Release 35 mg Twice Daily In Stable Angina Pectoris
Authors
Yuri M. Pozdnyakov
On behalf of the study investigators
Publication date
01-06-2018
Publisher
Springer Healthcare
Published in
Cardiology and Therapy / Issue 1/2018
Print ISSN: 2193-8261
Electronic ISSN: 2193-6544
DOI
https://doi.org/10.1007/s40119-018-0110-5

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