In a nutshell
This study investigated the effectiveness and safety of once-daily trimetazidine (Vastarel) in patients with stable angina (chest pain that occurs during physical activity). It was determined that once-daily trimetazidine reduced symptoms of angina, improved physical activity, and was well tolerated by most patients.
Some background
In coronary artery disease, blood vessels that supply the heart become narrowed or blocked. This reduces the blood flow to the heart. This can cause stable angina in many patients. Trimetazidine causes changes in the cells of the heart. This allows the heart to withstand reduced blood flow. Trimetazidine has been shown to reduce angina symptoms in people with stable angina. Usually, trimetazidine is taken twice, or three times, each day. A new altered form of trimetazidine, which can be taken once a day, may improve patient-satisfaction.
Methods & findings
3,066 adults with stable angina participated in this study. All patients received once-daily trimetazidine in addition to their usual medications. Data were collected at the start of the study, after 1 month, and after 3 months. Patients and their physicians answered questionnaires at these times.
Participants experienced fewer attacks of angina per week after receiving trimetazidine. The average number of angina attacks per week under this treatment was 0.9 after 3 months, compared to 2.2 after 1 month and 4.7 at the start of the study.
Some patients also used another type of medication, called nitrates. These are sprayed under the tongue, to reduce angina symptoms. After receiving trimetazidine participants used nitrates less frequently. After 3 months, participants used nitrates, on average, 0.7 times per week, compared to 1.9 times per week after 1 month, and 4.5 times per week at the start of the study.
Participants were asked about any limitations of their physical activity. After 3 months, 15% of participants reported no limitations, compared with 5% after 1 month, and 1% at the start. Furthermore, treatment adherence (correct taking of medication) improved during the study.
9 patients reported side effects during the study. The most common were nausea and dizziness. Two participants reported a headache. None of the side effects were severe.
The bottom line
The study concluded that once-daily trimetazidine improved angina symptoms, physical activity, and adherence. Overall, once-daily trimetazidine was satisfactory to patients and physicians.
The fine print
This study was funded by Servier, the manufacturers of trimetazidine. The participants in this study were not compared to a group of similar participants who did not receive trimetazidine. This makes the effects of trimetazidine in this study uncertain.
What’s next?
Discuss the use of once-daily trimetazidine with your physician.
Published By :
Advances in therapy
Date :
Aug 13, 2018
