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. 2018 Dec 20;5(2):e000706.
doi: 10.1136/openhrt-2017-000706. eCollection 2018.

Effect of ranolazine on glycaemia in adults with and without diabetes: a meta-analysis of randomised controlled trials

Ik Hur Teoh  1 , Moulinath Banerjee  1   2
Affiliations

Effect of ranolazine on glycaemia in adults with and without diabetes: a meta-analysis of randomised controlled trials

Ik Hur Teoh et al. Open Heart. .

Abstract

Background: Ranolazine is an antianginal drug reported to have hypoglycaemic effects.

Objectives: To assess the effect of ranolazine versus placebo on glycaemic control for adults with and without diabetes.

Methods: A systematic search of seven databases was conducted to identify all randomised controlled trials that compared the effect of ranolazine versus placebo on haemoglobin A1c (HbA1c) and/or fasting plasma glucose (FPG) and/or incidence of hypoglycaemia. We used mean differences in HbA1c and FPG to express intervention effect estimates and analysed the data with random-effects model for meta-analyses using Revman 5.3.

Results: We identified seven trials including 6543 subjects to assess the effect of ranolazine on HbA1c and/or FPG. A separate trial that included 944 subjects was included to assess the effect of ranolazine on hypoglycaemia. The change in HbA1c for all patients was -0.36% (95% CI -0.57% to -0.15%; p=0.0004, I2=78%). In patients with diabetes, the change in HbA1c was -0.41% (95% CI -0.58% to -0.25%; p<0.00001, I2=65%). There was no significant difference in FPG between ranolazine and placebo groups (-2.58 mmol/L, 95% CI -7.02 to 1.85; p=0.25; I2=49%) or incidence of hypoglycaemia between ranolazine and placebo groups (OR 1.70, 95% CI 0.89 to 3.26; p=0.61, I2=0%).

Conclusions: Our meta-analytic findings support the fact that ranolazine improves HbA1c without increasing the risk of hypoglycaemia. It therefore has a potential of having an additional benefit of improving glycaemic control in patients with chronic stable angina and diabetes.

Keywords: coronary artery disease; macrovascular disease; stable angina.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Change in HbA1c for all patients. (B) Change in HbA1c in patients with diabetes. (C) Change in HbA1c in patients with diabetes (Pettus -et al metformin add-on trial excluded).
Figure 2
Figure 2
Change in fasting plasma glucose in patients with diabetes.
Figure 3
Figure 3
ORs of incidence of hypoglycaemia in patients treated with ranolazine.
Figure 4
Figure 4
Summary of ranolazine induced change in glycaemia and its common components.
See this image and copyright information in PMC

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