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在稳定型心绞痛中,每日一次服用80毫克曲美他嗪缓释片与每日两次服用35毫克曲美他嗪缓释片的临床可接受性比较

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

作者信息

Pozdnyakov Yuri M

机构信息

Moscow Regional Cardiology Centre, Zhukovsky, Russia.

出版信息

Cardiol Ther. 2018 Jun;7(1):61-70. doi: 10.1007/s40119-018-0110-5. Epub 2018 May 19.

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 available for this article.

摘要

引言

曲美他嗪(TMZ)是一种抗缺血代谢药物,已证明其在心绞痛治疗中无论是单药治疗还是联合治疗均有效。研发出了一种新的80毫克缓释(MR)曲美他嗪制剂,该制剂每日服用一次(od),而不是像目前可用的35毫克曲美他嗪缓释制剂那样每日服用两次(bid),目的是简化用药方案。

方法

本研究是一项国际多中心、随机、双盲、平行组III期研究,治疗期为12周。在先前成功接受35毫克曲美他嗪缓释制剂治疗的患者中,评估了每日一次服用80毫克曲美他嗪缓释制剂与每日两次服用35毫克曲美他嗪缓释制剂的安全性。记录了紧急不良事件(EAE)、生物学参数、生命体征、12导联静息心电图(ECG)和加拿大心血管学会(CCS)分级。

结果

165例先前诊断为稳定型心绞痛且正在接受治疗的患者被随机分为接受每日一次80毫克曲美他嗪缓释制剂或每日两次35毫克曲美他嗪缓释制剂治疗。在80毫克曲美他嗪缓释制剂组中,发生≥1次紧急不良事件的患者较少(曲美他嗪缓释制剂35毫克组为17.1%,而该组为22.9%)。每组有3例患者报告了严重紧急不良事件。没有紧急不良事件需要调整剂量、停药或暂时中断研究治疗。生命体征、12导联心电图和实验室参数均未改变。两种治疗方法均未观察到CCS分级恶化。

结论

每日一次服用80毫克曲美他嗪缓释制剂和每日两次服用35毫克曲美他嗪缓释制剂具有相似的安全性。这种新的每日一次给药制剂可提高患者的治疗依从性,从而增强临床获益。

试验注册

ISRCTN注册库,ISRCTN 84362208。

资助

国际研究机构施维雅公司以及俄罗斯联邦莫斯科的施维雅公司。本文提供了通俗易懂的摘要。

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