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Experimental and early investigational drugs for angina pectoris
Islam Y Elgendy1, David E Winchester1, Carl J Pepine1
1a Division of Cardiovascular Medicine , University of Florida, and North Florida/South Georgia Veterans Health System , Gainesville , FL , USA.
Insights
New angina treatments are being explored, including older drugs, anti-inflammatory agents, and cell/gene therapies. Research is ongoing to find the best options for chronic stable angina management.
Area of Science:
- Cardiology
- Pharmacology
- Regenerative Medicine
Background:
- Ischemic heart disease (IHD) is a leading cause of mortality and morbidity in Western nations.
- Angina pectoris, the primary symptomatic manifestation of IHD, necessitates improved management strategies for chronic stable angina.
- Current therapeutic approaches for angina require enhancement to address patient needs effectively.
Purpose of the Study:
- To review traditional and investigational therapies for angina.
- To highlight emerging pharmacological, cell-based, gene-based, and herbal treatments.
- To discuss the future directions and challenges in angina therapy research.
Main Methods:
- A comprehensive literature review was performed.
- Databases searched include Medline, Cochrane, and clinical trial registries (US and Europe).
- Focus on traditional therapies and novel investigational agents for angina.
Main Results:
- Renewed interest in established anti-angina agents like perhexiline and amiodarone.
- Evaluation of anti-inflammatory agents (allopurinol, febuxostat) for angina treatment.
- Therapeutic angiogenesis research shows promise but faces challenges.
Conclusions:
- Investigational therapies offer potential advancements in managing chronic stable angina.
- Further research is needed to optimize patient selection for therapies like therapeutic angiogenesis.
- Future trials should focus on identifying the ideal patient populations for novel angina treatments.
Introduction:
Ischemic heart disease (IHD) is a major cause of death and disability among Western countries and angina pectoris is the most prevalent symptomatic manifestation. Strategies to improve management of chronic stable angina are a priority. Areas covered: A comprehensive review was conducted using the Medline and Cochrane databases as well as the clinical trial databases in the United States and Europe. Traditional therapies for angina will be discussed. This review particularly emphasizes investigational therapies for angina (including pharmacological agents, cell and gene based therapies, and herbal medications). Expert opinion: There has been renewed interest in older anti-angina agents (e.g., perhexiline, amiodarone, and phosphodiestrase-5 inhibitors). Other anti-inflammatory agents (e.g., allopurinol and febuxostat) are currently undergoing evaluation for angina therapy. Therapeutic angiogenesis continues to face some challenges. Future trials should evaluate the optimum patient population that would benefit from this form of therapy.