Key result
Epanolol was as efficacious as nifedipine for stable angina but had superior tolerability, with fewer patients reporting flushing, pedal oedema, or feeling unwell (p<0.01), and was preferred by 61%.
Why the study?
Does epanolol reduce anginal attacks and improve tolerability compared to nifedipine in patients with stable angina pectoris?
RCT (n=571)
Double-blind
crossover
Yes
Does epanolol reduce anginal attacks and improve tolerability compared to nifedipine in patients with stable angina pectoris?
Epanolol is as efficacious as nifedipine for managing stable angina but offers a superior tolerability profile and higher patient preference.
Offers better-tolerated option than nifedipine for stable angina; confirms efficacy parity with higher patient preference in RCT.
Epanolol (200 mg once daily) was compared with nifedipine (20 mg twice daily) in a multicentre, double-blind, randomised, crossover study in which 571 patients with stable angina pectoris were entered. Efficacy was assessed by anginal attack rate and short-acting nitrate consumption. Symptoms and treatment preference of the patients were assessed by questionnaires. Assessments were made at baseline and after each 4-week treatment period. Both treatments were equally efficacious as demonstrated by weekly anginal attack rates and nitrate usage. Of those patients who expressed a preference for treatment, 61% expressed a preference for epanolol compared with 39% for nifedipine. Significantly fewer patients reported experiencing flushing, pedal oedema or feeling generally unwell (p less than 0.01) during the epanolol treatment period. Patients withdrew from nifedipine treatment more often than from epanolol because of adverse effects. Hence, epanolol was found to be as efficacious as nifedipine in patients with stable angina pectoris, but exhibited a superior tolerability profile and was preferred by more patients.
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Blake et al. (2008) conducted an RCT in stable angina pectoris (n=571). Epanolol vs. Nifedipine (20 mg twice daily) was evaluated on anginal attack rate and short-acting nitrate consumption. Epanolol was as efficacious as nifedipine for stable angina but had superior tolerability, with fewer patients reporting flushing, pedal oedema, or feeling unwell (p<0.01), and was preferred by 61%.
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