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Prescription Diabetes Drugs
Posted by admin in Prescription Diabetes Drugs on August 29th, 2010
Ivabradine is effective for preventing angina in patients with diabetes mellitus and stable coronary artery disease (CAD), and has no impact on glucose metabolism, an analysis of clinical trial data shows.
The study supports a potential role for ivabradine as an alternative to beta blockers in the treatment of stable angina, say the study authors writing in the American Journal of Cardiology.
Ivabradine is a specific heart-rate-lowering antianginal agent that inhibits the If current, the primary modulator of spontaneous diastolic depolarization in the sinoatrial node. The drug has been evaluated in a clinical development program involving approximately 3000 patients with stable CAD, most of whom had angina.
In these studies, ivabradine demonstrated efficacy in preventing angina and myocardial ischemia and was shown to be non-inferior to the beta blocker atenolol and the calcium-channel blocker amlodipine. Accordingly, ivabradine is now recommended in European guidelines for the prevention of stable angina pectoris.
For the present study, Jeffrey Borer (State University of New York, USA) and colleagues pooled data from eight multicenter, randomized, double-blind, controlled clinical trials to evaluate the safety and efficacy of ivabradine in patients with diabetes mellitus. A total of 535 diabetic individuals were studied.
The pharmacokinetics of ivabradine were similar in diabetic and non-diabetic patients, Borer et al report.
As in non-diabetic individuals, ivabradine treatment in diabetic patients was associated with an approximately 15% reduction in resting heart rate and an improvement in exercise tolerance measures, including total exercise duration, time to onset of myocardial ischemia, and time to onset of angina.
Ivabradine therapy in diabetics was also associated with a reduction in the frequency of angina attacks but without any increase in rates of sinus bradycardia or visual disturbances (both known to be related to the action of ivabradine). Furthermore, ivabradine had no adverse impact on glucose metabolism or other safety/tolerability outcomes.
“Although beta blockers have been recommended as first-line treatment of stable angina, they are often not prescribed because of contraindications or intolerance,” write Borer et al.
“Ivabridine is effective in patients with diabetes mellitus and angina and is not associated with particular safety concerns or adverse effects on glucose metabolism in this population. Therefore, ivabradine represents an attractive alternative to beta-blockers.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009
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