Anti-Anginal Effectiveness and Tolerability of Trimetazidine Modified Release 80 Mg Once Daily in Stable Angina Patients in Real-World Practice

Abstract

Introduction: Trimetazidine (TMZ) was shown to reduce angina symptoms and increase the exercise capacity in stable angina (SA) patients. A new formulation allowing a once-daily (od) dosage could improve patients' satisfaction and adherence.

Methods: ODA was a 3-month, observational, multicenter, prospective Russian study in SA patients with persistent symptoms despite therapy. Angina attack frequency, short-acting nitrate (SAN) consumption, adherence to antianginal medications, and overall efficacy and tolerability of TMZ 80 mg od were assessed in a real-world setting.

Results: A total of 3066 patients were included (mean age 62.8, 48% male). After 3 months, TMZ 80 mg od treatment led to a significant (p < 0.001) decrease in angina attack frequency (from 4.7 ± 3.5 to 0.9 ± 1.3/week) and SAN use (from 4.5 ± 3.9 to 0.7 ± 1.3/week). Overall tolerability and effectiveness were rated as "very good" by the majority of physicians. Medication adherence improved significantly, with good adherence reported by 56% of patients (vs. 24% at baseline, p < 0.0001) and non-adherence by 3% (vs. 36% at baseline, p < 0.0001) at month 3. Patient satisfaction with TMZ od was 9.5 [on a scale of 1 to 10 (very satisfied)]. Patients reported improved physical activity: more patients reported no limitations (15% vs. 1% at baseline p < 0.01), slight limitation (46% vs. 5% at baseline, p < 0.001) or moderate limitation (30% vs. 23%, p < 0.01) and fewer patients reported substantial limitation (8% vs. 52% at baseline, p < 0.001) or very marked reduction (1% vs. 19% at baseline, p < 0.01) at month 3.

Conclusion: In this prospective, observational study, TMZ 80 mg od effectively reduced angina attacks and SAN consumption, improved physical activity and adherence and was well tolerated in chronic SA patients.

Trial registration: ISRCTN registry Identifier, ISRCTN97780949.

Funding: Servier. Plain language summary available for this article.

Keywords: Cardiology; Observational study; Real-world evidence; Stable angina; Trimetazidine.

Fig. 1

Changes in mean weekly angina attacks (^® Servier). M1 month 1, M3 month 3. *p < 0.001 compared to baseline

Fig. 2

Changes in number of short-acting nitrates taken per week (^® Servier). M1 month 1, M3 month 3. *p < 0.001 compared to baseline

Fig. 3

Changes in CCS class (^® Servier). M1 month 1, M3 month 3

Fig. 4

Self-reported patient physical activity (^® Servier). M1 Month 1, M3 Month 3

Fig. 5

Patient adherence to all anti-anginal medications (^® Servier). M1 Month 1, M3 Month 3