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Published in: Advances in Therapy 9/2018

Open Access 01-09-2018 | Original Research

Anti-Anginal Effectiveness and Tolerability of Trimetazidine Modified Release 80 Mg Once Daily in Stable Angina Patients in Real-World Practice

Authors: Maria G. Glezer, Vladimir A. Vygodin, on behalf of ODA investigators

Published in: Advances in Therapy | Issue 9/2018

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Abstract

Introduction

Trimetazidine (TMZ) was shown to reduce angina symptoms and increase the exercise capacity in stable angina (SA) patients. A new formulation allowing a once-daily (od) dosage could improve patients’ satisfaction and adherence.

Methods

ODA was a 3-month, observational, multicenter, prospective Russian study in SA patients with persistent symptoms despite therapy. Angina attack frequency, short-acting nitrate (SAN) consumption, adherence to antianginal medications, and overall efficacy and tolerability of TMZ 80 mg od were assessed in a real-world setting.

Results

A total of 3066 patients were included (mean age 62.8, 48% male). After 3 months, TMZ 80 mg od treatment led to a significant (p < 0.001) decrease in angina attack frequency (from 4.7 ± 3.5 to 0.9 ± 1.3/week) and SAN use (from 4.5 ± 3.9 to 0.7 ± 1.3/week). Overall tolerability and effectiveness were rated as “very good” by the majority of physicians. Medication adherence improved significantly, with good adherence reported by 56% of patients (vs. 24% at baseline, p < 0.0001) and non-adherence by 3% (vs. 36% at baseline, p < 0.0001) at month 3. Patient satisfaction with TMZ od was 9.5 [on a scale of 1 to 10 (very satisfied)]. Patients reported improved physical activity: more patients reported no limitations (15% vs. 1% at baseline p < 0.01), slight limitation (46% vs. 5% at baseline, p < 0.001) or moderate limitation (30% vs. 23%, p < 0.01) and fewer patients reported substantial limitation (8% vs. 52% at baseline, p < 0.001) or very marked reduction (1% vs. 19% at baseline, p < 0.01) at month 3.

Conclusion

In this prospective, observational study, TMZ 80 mg od effectively reduced angina attacks and SAN consumption, improved physical activity and adherence and was well tolerated in chronic SA patients.

Trial Registration

ISRCTN registry Identifier, ISRCTN97780949.

Funding

Servier.

Plain Language Summary

Plain language summary available for this article.
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.CrossRef 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.CrossRef
2.
go back to reference Moran AE, Forouzanfar MH, Roth GA, et al. The global burden of ischemic heart disease in 1990 and 2010: the Global Burden of Disease 2010 study. Circulation. 2014;129:1493–501.CrossRef Moran AE, Forouzanfar MH, Roth GA, et al. The global burden of ischemic heart disease in 1990 and 2010: the Global Burden of Disease 2010 study. Circulation. 2014;129:1493–501.CrossRef
3.
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.CrossRef 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.CrossRef
4.
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.CrossRef 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.CrossRef
5.
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.CrossRef 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.CrossRef
6.
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.CrossRef 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.CrossRef
7.
go back to reference Qintar M, Spertus JA, Gosch KL, et al. Effect of angina under-recognition on treatment in outpatients with stable ischemic heart disease. Eur Heart J Qual Care Clin Outcomes. 2016;2:208–14.CrossRef Qintar M, Spertus JA, Gosch KL, et al. Effect of angina under-recognition on treatment in outpatients with stable ischemic heart disease. Eur Heart J Qual Care Clin Outcomes. 2016;2:208–14.CrossRef
8.
go back to reference Shafiq A, Arnold S, Gosch K, et al. Patient and physician discordance in reporting symptoms of angina among stable coronary artery disease patients: Insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study. Am Heart J. 2016;175:94–100.CrossRef Shafiq A, Arnold S, Gosch K, et al. Patient and physician discordance in reporting symptoms of angina among stable coronary artery disease patients: Insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study. Am Heart J. 2016;175:94–100.CrossRef
9.
go back to reference Kronish I, Ye S. Adherence to cardiovascular medication: lessons learned and future direction. Prog Cardiovasc Dis. 2013;55:590–600.CrossRef Kronish I, Ye S. Adherence to cardiovascular medication: lessons learned and future direction. Prog Cardiovasc Dis. 2013;55:590–600.CrossRef
10.
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.CrossRef 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.CrossRef
11.
go back to reference Ferdinand KC, Senatore FF, Clayton-Jeter H, et al. Improving medication adherence in cardiometabolic disease: practical and regulatory implications. J Am Coll Cardiol. 2017;69:437–51.CrossRef Ferdinand KC, Senatore FF, Clayton-Jeter H, et al. Improving medication adherence in cardiometabolic disease: practical and regulatory implications. J Am Coll Cardiol. 2017;69:437–51.CrossRef
12.
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.CrossRef Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001;23:1296–310.CrossRef
13.
go back to reference Girerd X, Radauceanu A, Achard JM, et al. Evaluation of patient compliance among hypertensive patients treated by specialists. Arch Mal Coeur Vaiss. 2001;94:839–42 (Article in French).PubMed Girerd X, Radauceanu A, Achard JM, et al. Evaluation of patient compliance among hypertensive patients treated by specialists. Arch Mal Coeur Vaiss. 2001;94:839–42 (Article in French).PubMed
14.
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.CrossRef 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.CrossRef
15.
go back to reference Passeron J. Effectiveness of trimetazidine in stable effort angina due to chronic coronary insufficiency. A double-blind versus placebo study. Presse Med. 1986;15:1775–8.PubMed Passeron J. Effectiveness of trimetazidine in stable effort angina due to chronic coronary insufficiency. A double-blind versus placebo study. Presse Med. 1986;15:1775–8.PubMed
16.
go back to reference Koylan N, Bilge AK, Adalet K, Mercanoglu F, Buyukozturk K. Comparison of the effects of trimetazidine and diltiazem on exercise performance in patients with coronary heart disease. The Turkish trimetazidine study (TTS). Acta Cardiol. 2004;59:644–50.CrossRef Koylan N, Bilge AK, Adalet K, Mercanoglu F, Buyukozturk K. Comparison of the effects of trimetazidine and diltiazem on exercise performance in patients with coronary heart disease. The Turkish trimetazidine study (TTS). Acta Cardiol. 2004;59:644–50.CrossRef
17.
go back to reference Detry JM, Sellier P, Pennaforte S, Cokkinos D, Dargie H, Mathes P. Trimetazidine: a new concept in the treatment of angina. Comparison with propranolol in patients with stable angina. Trimetazidine European Multicenter Study Group. Br J Clin Pharmacol. 1994;37:279–88.CrossRef Detry JM, Sellier P, Pennaforte S, Cokkinos D, Dargie H, Mathes P. Trimetazidine: a new concept in the treatment of angina. Comparison with propranolol in patients with stable angina. Trimetazidine European Multicenter Study Group. Br J Clin Pharmacol. 1994;37:279–88.CrossRef
18.
go back to reference Chazov EI, Lepakchin VK, Zharova EA, et al. Trimetazidine in Angina Combination Therapy—the TACT study: trimetazidine versus conventional treatment in patients with stable angina pectoris in a randomized, placebo-controlled, multicenter study. Am J Ther. 2005;12:35–42.CrossRef Chazov EI, Lepakchin VK, Zharova EA, et al. Trimetazidine in Angina Combination Therapy—the TACT study: trimetazidine versus conventional treatment in patients with stable angina pectoris in a randomized, placebo-controlled, multicenter study. Am J Ther. 2005;12:35–42.CrossRef
19.
go back to reference Szwed H, Sadowski Z, Elikowski W, et al. Combination treatment in stable effort angina using trimetazidine and metoprolol: results of a randomized, doubleblind, multicentre study (TRIMPOL II). TRIMetazidine in POLand. Eur Heart J. 2001;22:2267–74.CrossRef Szwed H, Sadowski Z, Elikowski W, et al. Combination treatment in stable effort angina using trimetazidine and metoprolol: results of a randomized, doubleblind, multicentre study (TRIMPOL II). TRIMetazidine in POLand. Eur Heart J. 2001;22:2267–74.CrossRef
20.
go back to reference Ciapponi A, Pizarro R, Harrison J. Trimetazidine for stable angina. Cochrane Database Syst Rev. 2005;4: CD003614. Ciapponi A, Pizarro R, Harrison J. Trimetazidine for stable angina. Cochrane Database Syst Rev. 2005;4: CD003614.
21.
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.CrossRef 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.CrossRef
22.
go back to reference Jackevicius CA, Li P, Tu JV. Prevalence, predictors, and outcomes of primary nonadherence after acute myocardial infarction. Circulation. 2008;117:1028–36.CrossRef Jackevicius CA, Li P, Tu JV. Prevalence, predictors, and outcomes of primary nonadherence after acute myocardial infarction. Circulation. 2008;117:1028–36.CrossRef
23.
go back to reference Cramer JA. Effect of partial compliance on cardiovascular medication effectiveness. Heart. 2002;88:203–6.CrossRef Cramer JA. Effect of partial compliance on cardiovascular medication effectiveness. Heart. 2002;88:203–6.CrossRef
24.
go back to reference Pozdnyakov YM; study investigators. Clinical acceptability of trimetazidine modified-release 80 mg once daily versus trimetazidine modified-release 35 mg twice daily in stable angina pectoris. Cardiol Ther. 2018;7:61–70.CrossRef Pozdnyakov YM; study investigators. Clinical acceptability of trimetazidine modified-release 80 mg once daily versus trimetazidine modified-release 35 mg twice daily in stable angina pectoris. Cardiol Ther. 2018;7:61–70.CrossRef
Metadata
Title
Anti-Anginal Effectiveness and Tolerability of Trimetazidine Modified Release 80 Mg Once Daily in Stable Angina Patients in Real-World Practice
Authors
Maria G. Glezer
Vladimir A. Vygodin
on behalf of ODA investigators
Publication date
01-09-2018
Publisher
Springer Healthcare Communications
Published in
Advances in Therapy / Issue 9/2018
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-018-0756-3

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