TY - JOUR
T1 - Multi-centre experience on the use of perhexiline in chronic heart failure and refractory angina
T2 - old drug, new hope
AU - Phan, Thanh Trung
AU - Shivu, Ganesh Nallur
AU - Choudhury, Anirban
AU - Abozguia, Khalid
AU - Davies, Chris
AU - Naidoo, Ulasini
AU - Ahmed, Ibrar
AU - Yousef, Zaheer
AU - Horowitz, John
AU - Frenneaux, Michael
PY - 2009/9
Y1 - 2009/9
N2 - The objective of this study is to report on our 5-year collective experience on the use of perhexiline in the UK, in patients with chronic heart failure (CHF) and/or refractory angina with respect to 'real-life' drug side effects and toxicity, therapeutic drug level monitoring, 5 year mortality outcomes and predictors of response to perhexiline therapy.Data on clinical history, perhexiline monitoring, follow-up, and mortality were retrospectively collated from centralized perhexiline databases from two tertiary referral centres. A total of 151 patients were on perhexiline therapy at two UK tertiary referral centres. At 3-4 months, 68.8% of patients had drug level within the therapeutic range and 20.8% were above the therapeutic range. A total of 58.9% of patients reported to have felt better on the perhexiline (responders). The presence of refractory angina was an independent predictor of response to perhexiline therapy (odds ratio 2.84, 95% confidence interval 1.28-6.32, P = 0.01). Five-year mortality was non-significantly different between patients with refractory angina, CHF, or both (20.5, 31.0, and 38.4%, P = 0.20, respectively).Perhexiline therapy provides symptomatic relief in the majority of patients with minimal side effects or toxicity. Careful therapeutic level monitoring for dose titration is important to prevent acute and chronic toxicity. Patients with refractory angina were more likely to be responders.
AB - The objective of this study is to report on our 5-year collective experience on the use of perhexiline in the UK, in patients with chronic heart failure (CHF) and/or refractory angina with respect to 'real-life' drug side effects and toxicity, therapeutic drug level monitoring, 5 year mortality outcomes and predictors of response to perhexiline therapy.Data on clinical history, perhexiline monitoring, follow-up, and mortality were retrospectively collated from centralized perhexiline databases from two tertiary referral centres. A total of 151 patients were on perhexiline therapy at two UK tertiary referral centres. At 3-4 months, 68.8% of patients had drug level within the therapeutic range and 20.8% were above the therapeutic range. A total of 58.9% of patients reported to have felt better on the perhexiline (responders). The presence of refractory angina was an independent predictor of response to perhexiline therapy (odds ratio 2.84, 95% confidence interval 1.28-6.32, P = 0.01). Five-year mortality was non-significantly different between patients with refractory angina, CHF, or both (20.5, 31.0, and 38.4%, P = 0.20, respectively).Perhexiline therapy provides symptomatic relief in the majority of patients with minimal side effects or toxicity. Careful therapeutic level monitoring for dose titration is important to prevent acute and chronic toxicity. Patients with refractory angina were more likely to be responders.
KW - chronic heart failure
KW - refractory angina
KW - perhexiline
KW - mortality and drug monitoring
KW - maleate
KW - oxidation
KW - creatine
KW - pectoris
KW - disease
U2 - 10.1093/eurjhf/hfp106
DO - 10.1093/eurjhf/hfp106
M3 - Article
SN - 1879-0844
VL - 11
SP - 881
EP - 886
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 9
ER -