Post-marketing comparative clinical study of the efficacy and safety of Iso-Mik® spray and sublingual form of nitroglycerin

September 6, 2023
1018
УДК:  616.12-009.72+615.22
Resume

In Ukraine, in recent years, the number of cases and the incidence of angina has increased significantly, and forecast indicators indicate a trend of their growth.

Purpose: to study the comparative effectiveness and safety of isosorbide dinitrate — sublingual dosed spray Iso-Mik® and nitroglycerin tablets in patients with angina pectoris.

Object and research methods. The study included 30 patients with ischemic heart disease, stable angina pectoris II–III functional class aged 50 to 75 years. The average number of attacks was 12.7±1.0 per week. Patients used short-acting nitrates in tablet form to stop angina attacks — an average of 9.4±0.8 tablets per week against the background of modern medical therapy. Each patient performed two study protocols. Protocol 1 included a study of the effectiveness and safety of the sublingual form of nitroglycerin, protocol 2 was performed by each patient at least 24 hours after the completion of protocol 1 and included a study of the effectiveness and safety of the dosed drug Iso-Mik® spray.

The results. A post-marketing comparative study showed that Iso-Mik® spray is an effective antianginal drug in real clinical practice, which is well tolerated and does not cause side effects compared to nitroglycerin tablets. With an attack of angina pectoris, the use of Iso-Mik® spray almost halves the time it takes to stop the attack and significantly increases the duration of physical activity compared to nitroglycerin tablets.

References

  • 1. Tsao C.W., Aday A.W., Almarzooq Z.I. et al. (2023) Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation, 147(8): e93–e621. DOI: 10.1161/CIR.0000000000001123.
  • 2. Теренда Н.О. (2015) Тенденції та прогноз поширеності стенокардії та інфаркту міокарда в Україні Вісник соціальної гігієни та організації охорони здоров’я України, 65(3): 35–40. doi.org/10.11603/1681-2786.2015.3.5763.
  • 3. Іванюк А.В., Орлова Н.М. (2020) Ішемічна хвороба серця у населення працездатного віку Київської області: статистичний аналіз сучасної епідеміологічної ситуації. Вісн. Вінницького нац. мед. ун-ту, 24(14): 694–699.
  • 4. Manolis A.J., Ambrosio G., Collins P. et al. (2019) Impact of stable angina on health status and quality of life perception of currently treated patients. The BRIDGE 2 survey. Eur. J. Intern. Med., 70: 60–67. DOI: 10.1016/j.ejim.2019.09.013.
  • 5. Наказ МОЗ України від 23.12.2021 р. № 2857 «Про затвердження Уніфікованого клінічного протоколу первинної, вторинної (спеціалізованої) та третинної (високоспеціалізованої) медичної допомоги «Стабільна ішемічна хвороба серця»».
  • 6. Knuuti J., Wijns W., Saraste A. et al.(2020) 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur. Heart J., 41(3): 407–477.
  • 7. Virani S.S., Newby L.K., Arnold S.V. et al. (2023) 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. DOI: 10.1161/CIR.0000000000001168.
  • 8. Gulati M., Levy P.D., Mukherjee D. et al. (2021) 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 144(22): e368–e454.
  • 9. Jespersen L., Abildstrøm S.Z., Hvelplund A., Prescott E. (2013) Persistent angina: highly prevalent and associated with long-term anxiety, depression, low physical functioning, and quality of life in stable angina pectoris. Clin. Res. Cardiol., 102(8): 571–581. DOI: 10.1007/s00392-013-0568-z.
  • 10. Beltrame J.F., Weekes A.J., Morgan C. et al. (2009) The prevalence of weekly angina among patients with chronic stable angina in primary care practices: The Coronary Artery Disease in General Practice (CADENCE) Study. Arch. Intern. Med., 69(16): 1491–1499. DOI: 10.1001/archinternmed.2009.295.
  • 11. Boden W.E., Padala S.K., Cabral K.P. et al. (2015) Role of short-acting nitroglycerin in the management of ischemic heart disease. Drug Des. Devel. Ther., 19(9): 4793–805. DOI: 10.2147/DDDT.S79116.
  • 12. Kim C., Ha M., Kim W. et al. (2021) Nitrates administered by spray versus tablet: comparison of coronary vasodilation on CT angiography. Eur. Radiol., 31(1): 515–524.
  • 13. Boden W.E., Finn A.V., Patel D. et al. (2012) Nitrates as an integral part of optimal medical therapy and cardiac rehabilitation for stable angina: review of current concepts and therapeutics. Clin. Cardiol., 35(5): 263–271. DOI: 10.1002/clc.21993.