Angina drug ranolazine may improve glycemia in DM

  • Teoh IH & al.
  • Open Heart
  • 1 Jan 2018

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • The antianginal agent ranolazine (Ranexa) improves HbA1c without increasing hypoglycemia risk in patients with chronic stable angina and diabetes mellitus (DM).

Why this matters

  • Over half of patients with ischemic heart disease have abnormal glucose metabolism.

Study design                                                                  

  • Meta-analysis of 7 clinical trials with 6543 participants randomly allocated to ranolazine vs placebo for 8-24 weeks.
  • Funding: None disclosed.

Key results

  • Statistically significant HbA1c reduction for ranolazine vs placebo of 0.36% (P=.0004).
  • Among patients with diabetes, mean HbA1c reduction difference for ranolazine vs placebo was 0.41% (P<.00001>
  • No statistically significant difference in fasting plasma glucose between ranolazine and placebo groups (mean difference, −2.58 mmol/L in favor of ranolazine; P=.25).
  • Among patients with diabetes, hypoglycemia incidence did not differ between treatment groups (OR, 1.70; P=.61).

Limitations

  • Small number of trials; glycemia not primary outcome.
  • Heterogeneity of study populations.
  • Short duration in some studies.
  • Publication bias potential.