Document Detail


Efficacy and safety of controlled-release isosorbide-5-mononitrate in Japanese patients with stable effort angina pectoris.
MedLine Citation:
PMID:  17106140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A new controlled-release isosorbide-5-mononitrate (CR-ISMN) preparation has been developed to meet the requirement for a low nitrate concentration interval in order to avoid nitrate tolerance. We conducted a randomized, double-blind, placebo-controlled study in 31 Japanese patients with stable effort angina pectoris to investigate the efficacy and safety of CR-ISMN. Patients were randomly assigned to either CR-ISMN (40 mg once daily) or placebo groups for 2 weeks after two consecutive symptom-limited treadmill exercise tests using the Bruce protocol to ascertain the reproducibility of exercise tolerance during the placebo run-in period. Exercise tests were repeated at 5, 12, and 24 hours after administration on the final day. No significant difference in exercise time to moderate angina was identified between the CR-ISMN and placebo groups at 5, 12, or 24 hours after administration. However, the changes in exercise were prolonged at 5 hours but not shortened at 24 hours in the CR-ISMN group. The results of subgroup analysis suggested that the concomitant use of insulin might lead to confounding results. Although headache was the most frequent adverse effect in the CR-ISMN group, all symptoms were mild and at self-limiting levels. The plasma concentrations of CR-ISMN maintained therapeutic levels at 5 and 12 hours, and gradually decreased to less than the minimum therapeutic concentration (100 ng/mL) at 24 hours after administration. This study demonstrates that CR-ISMN improves exercise tolerance during the daytime and is well-tolerated in Japanese patients with stable effort angina pectoris without increasing the number of serious adverse effects.
Authors:
Kazunori Shimada; Satoshi Sunayama; Kaoru Nakazato; Hiroyuki Satoh; Yoshiki Kusama; Kiyoshi Kawakubo; Hiroyuki Daida
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  International heart journal     Volume:  47     ISSN:  1349-2365     ISO Abbreviation:  -     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-11-19     Completed Date:  2007-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  695-705     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / drug therapy*,  physiopathology
Delayed-Action Preparations
Double-Blind Method
Drug Tolerance
Exercise Test
Exercise Tolerance
Female
Humans
Isosorbide Dinitrate / administration & dosage,  analogs & derivatives*,  blood
Male
Middle Aged
Reproducibility of Results
Treatment Outcome
Vasodilator Agents / administration & dosage*,  blood
Chemical
Reg. No./Substance:
0/Delayed-Action Preparations; 0/Vasodilator Agents; 16051-77-7/isosorbide-5-mononitrate; 87-33-2/Isosorbide Dinitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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