A nationwide questionnaire-based survey on practice patterns and management of chronic stable angina with a controlled release formulation of trimetazidine
Keywords:Chronic stable angina, Trimetazidine, Questionnaire-based survey
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.
Glezer MG, Vygodin VA, ODA investigators. Anti-anginal effectiveness and tolerability of Trimetazidine modified release 80 mg once daily in stable angina patients in real-world practice. Adv Ther. 2018;35(9):1368-77.
Rousan TA, Mathew ST, Thadani U. Drug therapy for stable angina pectoris. Drugs. 2017;77(3):265-84.
Walters MA. Management of chronic stable angina. Crit Care Nurs Clin North Am. 2017;29(4):487-93.
Gupta R, Sawhney JP, Narain VS. Treatment of stable angina pectoris with Trimetazidine modified release in Indian primary-care practice. Am J Cardiovasc Drugs. 2005;5(5):325-9.
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(1):61-70.
Ciapponi A, Pizarro R, Harrison J. Trimetazidine for stable angina. Cochrane Database Syst Rev. 2005;(4):CD003614.
Javeer SD, Pandit R, Jain SP, Amin P. Formulation and evaluation of trimetazidine dihydrochloride extended release tablets by melt congealing method. Indian J Pharm Sci. 2010;72(6):704-9.
Harahap Y, Budi Prasaja MM, Lusthom W, Hardiyanti, Azmi F, Felicia V, et al. Bioequivalence of trimetazidine modified release tablet formulations assessed in Indonesian subjects. J Bioequiv Availab. 2013;5:117-20.
Anthoine E, Moret L, Regnault A, Sébille V, Hardouin JB. Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures. Health Qual Life Outcomes. 2014;12:2.
Rosano GM, Vitale C, Sposato B, Mercuro G, Fini M. Trimetazidine improves left ventricular function in diabetic patients with coronary artery disease: a double-blind placebo-controlled study. Cardiovasc Diabetol. 2003;2:16.
Tarkin JM, Kaski JC. Trimetazidine: Is there a role beyond angina? Eur Heart J Cardiovasc Pharmacother. 2018;4:67-8.
Belardinelli R. Trimetazidine and the contractile response of dysfunctional myocardium in ischaemic cardiomyopathy. Rev Port Cardiol. 2000;19:35-9.
Jain A, Elgendy IY, Al-Ani M, Agarwal N, Pepine CJ. Advancements in pharmacotherapy for angina. Expert Opin Pharmacother. 2017;18(5):457-69.
Balla C, Pavasini R, Ferrari R. Treatment of angina: Where are we? Cardiology. 2018;140(1):52-67.
Glezer M, CHOICE-2 study investigators. The effectiveness of trimetazidine treatment in patients with stable angina pectoris of various durations: Results from the CHOICE-2 study. Adv Ther. 2018;35(7):1103-13.
Glezer M. Real-world Evidence for the Antianginal Efficacy of Trimetazidine from the Russian Observational CHOICE-2 Study. Adv Ther. 2017;34(4):915-24.
Dézsi CA. Trimetazidine in practice: Review of the clinical and experimental evidence. Am J Ther. 2016;23(3):871-9.
Selvarajan S, Dkhar SA, Pillai AA, George M, Jayaraman B, Chandrasekaran A. Comparison of ranolazine and Trimetazidine on glycemic status in diabetic patients with coronary artery disease - A randomized controlled trial. J Clin Diagn Res. 2015;9(1):OC01-5.
Divchev D, Stöckl G; study investigators. Effectiveness and impact on adherence of a new fixed-dose combination of ivabradine and metoprolol in a wide range of stable angina patients in real-life practice. Cardiol Ther. 2019;8(2):317-28.
Van der Laan DM, Elders PJM, Boons CCLM, Nijpels G, Hugtenburg JG. Factors associated with nonadherence to cardiovascular medications: A cross-sectional study. J Cardiovasc Nurs. 2019;34(4):344-52.