was dipyridamole disregarded too soon?

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Was Dipyridamole Disregarded Too Soon? Meta-analysis of 11 trials suggests that dipyridamole may be useful in angina Although dipyridamole has been marketed in the USA since 1959, the value of this drug in the treatment of angina pectoris has never been fully investigated. Therefore, a meta-analysis was performed on 11 relevant double-blind placebo-controlled trials. Patients received dipyridamole 37 . 5-225 mg/day for 2 weeks to 7 months. \ Of the 11 trials, 3 showed a significant benefit with dipyridamole over placebo, 4 showed a trend in favour of dipyridamole, 2 showed no difference between treatments and 2 showed a trend favouring placebo. The 3 trials that showed a significant benefit with dipyridamole used doses 100 mg/day for between 2-7 months. Two different statistical methods supported the superiority of dipyridamole over placebo in angina. Using the worst case data, only one statistical method showed a significant benefit with dipyridamole. 25 adverse events, excluding deaths, were reported in dipyridamole recipients and 17 in placebo recipients. Of the 13 deaths reported , 3 patients were receiving placebo, 4 were receiving dipyridamole and information was lacking for 6 patients. From the combined analysis of 11 trials dipyridamole was shown to have a significant benefit in patients with angina pectoris, especially at higher doses and for longer periods of therapy. Thus, the authors concluded that, as antianginal prophylaxis, dipyridamole ' ... may have been disregarded prematurely'. Sacks HS. Ancona·Berk VA, Berrier J, Nagalingam R, Chalmers TC. Clinical Pharmcology and Therapeutics 43: 610·615, Jun 1988 7507 8 INPHARMA " 3 Sep 1988 0156-2703/88/0903-0008/0$01.00/0 © ADIS Preu

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Page 1: Was Dipyridamole Disregarded Too Soon?

Was Dipyridamole Disregarded Too Soon? Meta-analysis of 11 trials suggests that dipyridamole may be useful in angina

Although dipyridamole has been marketed in the USA since 1959, the value of this drug in the treatment of angina pectoris has never been fully investigated. Therefore, a meta-analysis was performed on 11 relevant double-blind placebo-controlled trials. Patients received dipyridamole 37.5-225 mg/day for 2 weeks to ~ 7 months. \

Of the 11 trials, 3 showed a significant benefit with dipyridamole over placebo, 4 showed a trend in favour of dipyridamole, 2 showed no difference between treatments and 2 showed a trend favouring placebo. The 3 trials that showed a significant benefit with dipyridamole used doses ~ 100 mg/day for between 2-7 months. Two different statistical methods supported the superiority of dipyridamole over placebo in angina. Using the worst case data, only one statistical method showed a significant benefit with dipyridamole. 25 adverse events, excluding deaths, were reported in dipyridamole recipients and 17 in placebo recipients. Of the 13 deaths reported , 3 patients were receiving placebo, 4 were receiving dipyridamole and information was lacking for 6 patients.

From the combined analysis of 11 trials dipyridamole was shown to have a significant benefit in patients with angina pectoris, especially at higher doses and for longer periods of therapy. Thus, the authors concluded that, as antianginal prophylaxis, dipyridamole ' ... may have been disregarded prematurely'. Sacks HS. Ancona·Berk VA, Berrier J, Nagalingam R, Chalmers TC. Clinical Pharmcology and Therapeutics 43: 610·615, Jun 1988 7507

8 INPHARMA" 3 Sep 1988 0156-2703/88/0903-0008/0$01.00/0 © ADIS Preu