Antinociceptive effect of ranolazine and trimetazidine

ABSTRACT

Background:Ranolazine and trimetazidine are piperazine derivatives used in antianginal therapy. There are data on the use of these drugs in the treatment of neuropathic pain. In this study, it was aimed to evaluate the antinociceptive effects of ranolazine and trimetazidine.

Methods: Sixty patients who were started on trimetazidine or ranolazine treatment were included in the study. The patients were evaluated with Seattle Angina Questionnaire (SAQ), Visual Analog Scale (VAS) and State-Trait Anxiety Inventory (STAI) on the first day of treatment and at the first month follow-up.

Results: The SAQ scores of the patients given ranolazine were statistically significantly higher than the patients given trimetazidine. The most significant increase was observed in terms of treatment satisfaction (53.03 ± 8.11 vs. 72.88 ± 5.29, p < 0.001) and quality of life (49.79 ± 8.62 vs. 68.01 ± 0.65, p = 0.016). The decrease in VAS (p = 0.001) and the decrease in STAI scores (p = 0.002) after treatment in the ranolazine group were significantly higher than in the trimetazidine group.

Conclusions: Ranolazine and trimetazidine are two effective drugs in antianginal treatment. While both drugs are effective on general systemic musculoskeletal pain and anxiety, the efficacy of ranolazine is more pronounced.

KEYWORDS:

• Angina
• trimetazidine
• ranolazine
• neuropathic pain
• antinociceptive effect

Highlights

• Ranolazine and trimetazidine are piperazine derivative drugs used in antianginal treatment.

• There are animal studies showing that other piperazine-derived drugs are effective in analgesic efficacy and use in neuropathic pain.

• Ranolazine and trimetazidine are effective on angina assessed by SAQ, anxiety assessed by STAI scale, and systemic musculoskeletal pain assessed by VAS.

• Both drugs are effective on general systemic musculoskeletal pain and anxiety, the efficacy of ranolazine is more pronounced. Further studies with evidence of ischemia supported by quantitative data on the antinociceptive efficacy of ranolazine and trimetazidine and the development of tolerance to drug efficacy are required.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

 A reviewer on this manuscript has disclosed that they have worked on several pharma-supported trials alongside consulting for pharma companies. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Statement of ethics

This prospective study was completed with the permission of the Chair of Health Sciences University Ankara City Hospital Clinical Research Ethics Committee (E1-20-814).

Additional information

Funding

This paper was not funded.