Ranolazine For Angina Treatment

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Main Category: Clinical Trials / Drug Trials
Also Included In: Heart Disease;  Primary Care / General Practice
Article Date: 10 Oct 2008 - 13:00 PST

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Ranolazine, a new treatment for chronic, stable angina, is discussed as a safe and effective option for patients in a New Drug Class paper released on October 10, 2008 in The Lancet.

Chronic stable angina is a prolonged chest pain which is often linked to heart disease. It is often present when the patient is exercising. This kind of angina is highly prevalent in developed nations, and in the United States, 9.1 million have the condition. There are 30 times as many angina patients admitted to hospitals as heart attack victims.

Current treatments for angina include β blockers, statins, aspirin, and diet and exercise. In 1986, ranolozine was patented, then further approved for use in the USA in 2006. It is indicated for angina patients whose symptoms continue even after trying one or more of the standard treatments.

According to the article, written by Dr Stephen Nash and Dr David Nash of Syracuse Preventive Medicine, NY, USA, ranzoline has been assessed in several randomized, controlled trials, including MARISA, CARISA, and ERICA. In these, it was shown to extend the amount of time that patients could continue to exercise before experiencing an attack of angina. Additionally, patients suffered an average of one attack less per week. The drug was more effective for exercise in men than in women, despite angina's higher prevalence in women.

The drug's side effects include nausea, constipation, and dizziness. While questions still remain over the drug's cost-effectiveness, as it can cost between $207 and $413 USD for just 30 days of medication, the authors say: "Expense must be balanced against the cost of an alternative therapy. In chronic stable angina, the alternative is often an invasive revascularisation."

The authors conclude that ranolazine should be used in addition to the traditional treatment regimen for chronic stable angina:  “Ranolazine seems to be a safe addition to current traditional drugs for chronic stable angina, especially in aggressive multidrug regimens...physicians in practice understand that lifestyle changes, including a low-fat diet with low cholesterol, a near-vegetarian diet, a regular exercise programme with excellent compliance, and a programme of stress-reduction measures are important in the treatment and prevention of angina. Studies of combinations of these lifestyle changes have shown efficacy in reducing the symptoms of chronic stable angina. Combination of such interventions with the use of ranolazine should be studied in carefully designed controlled trials, and almost certainly will be. The future outlook for patients with chronic stable angina should then be brighter.”

Ranolazine for chronic stable angina
David T Nash, Stephen D Nash
Lancet 2008; 372: 1335-41
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Written by Anna Sophia McKenney
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