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Ranolazine: A novel metabolic modulator for the treatment of chronic stable angina
Current medical therapy for chronic stable angina (CSA) is targeted at reducing the frequency of anginal symptoms and improving exercise tolerance by increasing myocardial oxygen supply and/or reducing myocardial oxygen demand. Pharmacological therapy for CSA is limited since traditional agents provide pain relief by reducing the work of the heart or dilating arterioles in an attempt to enhance supply. Combinations of these agents can induce profound reductions in blood pressure that limit the aggressive dosing needed in some patients. Metabolic modulators seek to overcome this issue through a novel mechanism of action. Ranolazine (Renexa, CV Therapeutics) is a partial fatty oxidase (pFOX) inhibitor that increases the amount of ATP produced from glucose and increases the ability of the myocardium to retain functionality despite a reduced oxygen supply. (Formulary 2003;38:461?476)
FDA Approves Combination Therapy for Pulmonary Arterial Hypertension
March 25th 2024J&J’s Opsynvi is single-tablet combination of macitentan, an endothelin receptor antagonist, and tadalafil, a PDE5 inhibitor. It will be priced on parity with Opsumit, which is also a J&J product to treat patients with PAH.
FDA Issues Complete Response Letter for Onpattro in Heart Failure Indication
October 9th 2023Alnylam Pharmaceuticals will no longer pursue this indication of Onpattro and will instead on focus on a label expansion for Amvuttra, which is in phase 3 development to treat patients with cardiomyopathy of ATTR amyloidosis.
