A nationwide questionnaire-based survey on practice patterns and management of chronic stable angina with a controlled release formulation of trimetazidine

Background: There is lack of real-world evidence on various aspects of chronic stable angina (CSA). Hence, a questionnaire-based survey was conducted to garner real-world data about the prevalence of CSA among Indian patients; the associated comorbidities among these patients; management practices for CSA in India; and factors affecting compliance in patients with CSA with a special focus on day and night pack for trimetazidine controlled release (CR) 35 mg BD tablets.Methods: In all, 100 health care practitioners (HCPs) who each observed 15 patients with CSA in their clinical practice participated in this quantitative, cross-sectional, questionnaire-based study. The data were collected using a structured questionnaire with 30 questions grouped into 5 sections. Data were analyzed using percentages.Results: The results from the survey showed that 52.7% HCPs had observed 31-50% of angina patients with diabetes mellitus as comorbidity. As per the questionnaire survey, 77.4% HCPs preferred trimetazidine as a second-line agent when an angina patient was not responding to beta-blockers, calcium channel blockers (CCBs), and nitrates. Furthermore, 30.1% of HCPs preferred trimetazidine CR 35 mg BD as it improved exercise tolerance as well. Results from the survey reported that 65.6% HCPs agreed with the statement that day and night packs of trimetazidine tablets help in improving patient compliance and adherence to therapy.Conclusions: Trimetazidine CR 35 mg BD appears to have a safety profile suitable for various conditions and for patients with multiple comorbidities. Trimetazidine day and night packs of tablets help in improving patient compliance and adherence to therapy.

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Chronic stable angina

The ESC Handbook on Cardiovascular Pharmacotherapy ◽

10.1093/med/9780198759935.003.0006_update_001 ◽

2019 ◽

pp. 91-106

Author(s):

Gaetano Antonio Lanza ◽

Antonio De Vita

Keyword(s):

Stable Angina ◽

Myocardial Oxygen Consumption ◽

Beta Blockers ◽

Chronic Stable Angina ◽

Pharmacological Therapy ◽

Lifestyle Changes ◽

Channel Blockers ◽

Variable Combination ◽

Improve Clinical Outcome ◽

Risk Factor Burden

Treatment of patients with chronic stable angina has two main objectives: to improve clinical outcome and to reduce angina symptoms. Prognosis is mainly improved by a reduction in cardiovascular risk factor burden, which may be achieved by appropriate lifestyle changes and, for some risk factors (e.g. hypercholesterolaemia, hypertension, diabetes), appropriate pharmacological therapy (including, in particular, statins and renin–angiotensin–aldosterone system inhibitors) and use of antithrombotic agents. Symptoms can be improved by a variable combination of traditional (beta-blockers, calcium channel blockers, nitrates) and novel (e.g. ivabradine, ranolazine) anti-ischaemic drugs, which may act through reduction in myocardial oxygen consumption and/or improvement of myocardial perfusion.

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Treatment of Chronic Stable Angina with Carvedilol: A Multiple-Action Neurohormonal Antagonist. A Review of Controlled Clinical Trials

Journal of International Medical Research ◽

10.1177/030006059802600301 ◽

1998 ◽

Vol 26 (3) ◽

pp. 107-119 ◽

Cited By ~ 4

Author(s):

I González Maqueda

Keyword(s):

Stable Angina ◽

Oxygen Free Radicals ◽

Beta Blockers ◽

Chronic Stable Angina ◽

Oxygen Demand ◽

Myocardial Oxygen Demand ◽

Channel Blockers ◽

Side Effect Profile ◽

Controlled Clinical Trials ◽

Ischaemic Damage

Beta-blockers and vasodilators, such as nitrates and calcium channel blockers, are all established antianginal therapies. These therapies have different antianginal mechanisms that dictate both their mode of action and their side-effect profile. An agent with both cardiac beta- and vascular alpha-receptor activity offers advantages over these conventional drugs. Carvedilol, a multiple-action neurohormonal antagonist, has potent antihypertensive and antianginal activity. Through its combination of pharmacological mechanisms, it reduces myocardial oxygen demand, increases myocardial blood supply and scavenges oxygen free radicals, which are capable of ischaemic damage. Studies have shown that carvedilol is at least as effective as other antianginal therapies in the management of chronic stable angina. Carvedilol is well tolerated – in several cases, the overall incidence of adverse events being lower than with other antianginal agents. These properties, combined with the documented antianginal effects, suggest that carvedilol may prove useful for the treatment of patients with chronic stable angina.

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Analysis of real world patient compliance to everolimus-based therapy among post-menopausal women with hormone receptor positive and human epidermal growth factor receptor 2 negative (HR+/HER2-) metastatic breast cancer (mBC).

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e12546 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e12546-e12546 ◽

Cited By ~ 1

Author(s):

Nicole Princic ◽

Matthew Brouillette ◽

Derek Tang ◽

Chinjune Lin ◽

Brad Lanoue ◽

...

Keyword(s):

Patient Compliance ◽

Real World ◽

Total Duration ◽

Medication Possession Ratio ◽

Secondary Malignancy ◽

Real World Data ◽

World Data ◽

Post Menopausal ◽

Line Of Therapy

e12546 Background: Patient compliance, typically not captured in clinical trials, may have profound effects on treatment effectiveness. As there has been limited real-world data, the objective of this analysis was to examine compliance among HR+/HER2- mBC patients treated with everolimus as a second or later line of therapy in the US across age groups. Methods: In this retrospective cohort study, the MarketScan Commercial and Medicare Supplemental claims databases were used to select post-menopausal HR+/HER2- mBC women who initiated an everolimus-based line of therapy during 1/1/2013- 7/31/2016 study period. The first secondary malignancy diagnosis was the index date. Patients had 6 months of continuous enrollment in their health plans pre- and post- index, and were followed until the earliest of disenrollment, inpatient death, or end of study. Compliance was measured using medication possession ratio (MPR) during a second (2L), third (3L) and fourth (4L) line of therapy. MPR was defined as total days of supply of everolimus during the line of therapy divided by total duration of the line. Results: Of 645 eligible mBC patients treated with everolimus during follow-up, there were 239, 142, and 80 with a 2L, 3L, and 4L of therapy respectively. Mean age overall was 61.1 + 11.7 years and average duration of follow-up was 718.3 + 304.1 days. Across all patients the median MPR ranged during each line from 0.90-0.92 and the majority (93.8%-97.5%) were highly compliant to therapy (defined as MPR>80%). These results were consistent for patients aged <65 and 65+ years across a 2L, 3L, and 4L of therapy (Table). Conclusions: This study shows high compliance for everolimus-based therapy within a 2L, 3L, and 4L of therapy and this is consistent across ages. This real world data suggests good drug manageability and may provide valuable information for clinicians in selecting treatment for mBC. [Table: see text]

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