Lercanidipine In Patients Research Articles

Urine cytokine profile and nephroprotective effect of lercanidipine in patients with urolithiasis with obstructive uropathy before and after nephrostomy

Objective. To study the nephroprotective effect of lercanidipine and its influence on creatinine clearance and cytokine damage in patients with urolithiasis with obstructive uropathy.
 Material and methods. Of 96 patients evaluated, 66 were diagnosed with kidney stones in the ureteropelvic segment and obstructive uropathy, which was then treated with percutaneous nephrostomy. All 66 patients were given antibacterial and anti-inflammatory therapy to prevent postoperative infections, but in addition, 33 were treated with lercanidipine, 10 mg per day. IL-8, VEGF, MCP-1, G-CSF, and GM-CSF concentrations in the urine were determined by solid-phase ELISA. The estimated glomerular filtration rate was calculated using the CKD-EPI formula. All studies were done preoperatively and on days 7, 14, 21, and 28 after nephrostomy. A control group consisted of 30 people with kidney stones without sings of obstruction.
 Results. In the patients with obstructive uropathy, a correlation was found between VEGF, IL-8, and MCP-1 concentrations in the urine and the serum creatinine and estimated glomerular filtration rate. Patients in the lercanidipine group had a faster decrease in IL-8, VEGF, MCP-1, and GM-CSF concentrations in the urine and improved renal function compared with patients who did not receive lercanidipine. By day 21 after nephrostomy, the lercanidipine group had values comparable with the control group, whereas the group not treated with lercanidipine did not achieve similar values until day 28.
 Conclusion. The third generation calcium channel blocker lercanidipine is nephroprotective in patients with obstructive uropathy.

Organoprotection with arterial hypertension 2-3 degrees

Objective. Arterial hypertension (AH) is one of the most common and socially significant diseases worldwide. Despite years of experience gained in studying hypertension, the problems concerning selection of antihypertensive therapy with pleiotropic organ-protecting effects are still of current importance. Purpose - to assess therapeutic efficacy and pleiotropic organ-protective capability of third-generation calcium antagonist lercanidipine in patients with stage 2-3 hypertension. Materials and methods. Our study enrolled a total of ninety-two 31-to-84-year-old patients. Of these, 72 patients diagnosed as having stage 2 or 3 AH composed the Study Group and 20 apparently healthy subjects were included into the Control Group. At baseline and after 6 months, all patients of the Study Group underwent examinations consisting in measuring biochemical parameters [total cholesterol (TCH), triglycerides, low-density lipoprotein cholesterol (LDL CH), uric acid, urea, creatinine, glucose], 24-hour ambulatory BP monitoring, echocardiography in order to assess the dimensions and volume of the cardiac chambers, thickness of the left ventricular posterior wall (LVPW) and left-ventricular myocardium mass index (LVMMI), studying microalbuminuria (MAU), a known marker of endothelial dysfunction and early renal lesion; assessing the state of the vascular wall by the ankle-brachial index (ABI) and pulse pressure (PP). Antihypertensive therapy consisted in lercanidipine alone taken at a dose of 10-20 mg/day, failure to thereby achieve the target BP level was followed by additionally prescribing an angiotensin converting enzyme (ACE) inhibitor, enalapril, given at a dose of 5-20 mg twice daily. Results. All patients by the end of the study achieved the target level of AP (p≤0.05), also demonstrating significantly improved (p≤0.01) parameters of endothelial dysfunction and an early marker of renal damage (MAU), indices of elastic properties of the vascular wall ABI (p≤0.05) and PP (p=0.01). Significantly positive dynamics was observed for the following parameters: decreased creatinine concentration (p≤0.001), increased GFR (p≤0.001), decreased levels of TCH (p≤0.01) and LDL CH (p≤0.001). Conclusion. Lercanidipine therapy of patients with stage 2-3 AH proved highly efficient, well tolerated, metabolically neutral with pleiotropic organprotecting properties in the form of improved condition of the vascular wall, correction of endothelial dysfunction, nephroprotective action

Effective end-organ protection in arterial hypertension: possibilities of third-generation calcium antagonists

Objective:Arterial hypertension (AH) is one of the most common and socially significant diseases worldwide. Despite years of experience gained in studying hypertension, the problems concerning selection of antihypertensive therapy with pleiotropic organ-protecting effects are still of current importance. The purpose of the study was to assess therapeutic efficacy and pleiotropic organ-protective capability of third-generation calcium antagonist lercanidipine in patients with stage 2-3 hypertension.Method:Our study enrolled a total of ninety-two 31-to-84-year-old patients. Of these, 72 patients diagnosed as having stage 2 or 3 AH composed the Study Group and 20 apparently healthy subjects were included into the Control Group. At baseline and after 6 months, all patients of the Study Group underwent examinations consisting in measuring biochemical parameters [total cholesterol (TCH), triglycerides (TG), low-density lipoprotein cholesterol (LDL CH), uric acid, urea, creatinine, glucose], 24-hour ambulatory BP monitoring, echocardiography (EchoCG) in order to assess the dimensions and volume of the cardiac chambers, thickness of the left ventricular posterior wall (LVPW) and left-ventricular myocardium mass index (LVMMI), studying microalbuminuria (MAU) , a known marker of endothelial dysfunction and early renal lesion; assessing the state of the vascular wall by the ankle-brachial index (ABI) and pulse pressure (PP). Antihypertensive therapy consisted in lercanidipine alone taken at a dose of 10-20 mg/day, failure to thereby achieve the target BP level was followed by additionally prescribing an angiotensin converting enzyme (ACE) inhibitor, enalapril, given at a dose of 5-20 mg twice daily.Results:All patients by the end of the study achieved the target level of AP (p<0.05), also demonstrating significantly improved (p<0.01) parameters of endothelial dysfunction and an early marker of renal damage (MAU), indices of elastic properties of the vascular wall ABI (p<0.05) and PP (p=0.01). Significantly positive dynamics was observed for the following parameters: decreased creatinine concentration (p<0.001), increased GFR (p<0.001), decreased levels of TCH (p<0.01) and LDL CH (p<0.001).Conclusion:Lercanidipine therapy of patients with stage 2 - 3 AH proved highly efficient, well tolerated, metabolically neutral with pleiotropic organ-protecting properties in the form of improved condition of the vascular wall, correction of endothelial dysfunction, nephroprotective action.

Left Ventricular Structure during Antihypertensive Treatment in Patients with Chronic Kidney Disease

The aim of our study was to investigate the left ventricular (LV) echocardiographic parameters and estimate the antiremodeling efficacy of eprosartan and lercanidipine in patients with chronic kidney disease, depending on the presence or absence of diabetic nephropathy (DN). Materials and Methods: The study included 121 patients (mean age 52.4±5.7 years) with CKD stage 3 (KDOQI, 2002). Patients were distributed in two groups according to the etiology of CKD. Group 1 consisted of 67 patients with non-diabetic CKD. Group 2 consisted of 54 CKD patients with DN. All patients had arterial hypertension grade 1 or 2 (ESH/ESC, 2013). All patients underwent clinical examination, echocardiography; GFR was estimated by the Cockcroft-Gault formula. Stages of chronic kidney disease (CKD) were determined according to the KDOQI 2002 classification. Eprosartan and lercanidipine were prescribed to patients after one week of lavage from previous antihypertensive therapy. This 6-month follow-up study compared the effectiveness of two courses of treatment. Results: Left ventricular hypertrophy (LVH) was observed in all CKD patients regardless of the presence or absence of DN. Eprosartan and lercanidipine showed the high antihypertensive efficacy expressing a reliable decrease in absolute values of SBP and DBP. In CKD patients with DN, on the background of a comparable antihypertensive effect, eprosartan, in comparison with lercanidipine, showed a more pronounced effect on the LV echocardiographic parameters associated with LVH regression. (Int J Biomed. 2015;6(1):18-21.).

A modern choice for patients with hypertension: the possibility of new calcium antagonist of III generation

Features and possibility of application of the calcium channel blocker lercanidipine in cardiology practice are discussed. The use of lercanidipine in patients with hypertension is supported by extensive evidences. The use of lercanidipine in certain categories of patients, including patients receiving combination therapy is also considered. The safety of lercanidipine in cardiac patients is discussed separately.

Can lercanidipine improve renal function in patients with atherosclerotic renal artery stenosis undergoing renal artery intervention?

Objective:To investigate the renal-protective effect of lercanidipine in patients undergoing renal artery intervention.Methods:A prospective, single-center, cohort study was conducted and patients, 30–75 years of age, with atherosclerotic renal artery stenosis were consecutively enrolled between September 2011 and October 2012. Lercanidipine (10–20 mg/day) was regularly taken after the intervention. Follow up visits were performed at 3 and 6 months after the intervention. Serum creatinine, clinical blood pressure, 24 hour ambulatory blood pressure, pulse wave velocity, and 24 hour urine protein were assessed. Adverse events were recorded.Results:In total, 55 patients (mean age 63.5 ± 8.9 years) were enrolled and 52 completed the study. Renal function, estimated glomerular filtration rate (eGFR) and 24 hour urine protein at 3 months after the intervention were not statistically different compared with the baseline. At 6 months after the intervention eGFR significantly increased versus baseline (78 ± 23 ml/min/1.73 m2 vs 71 ± 21 ml/min/1.73 m2, p = 0.021); 24 hour urine protein decreased significantly (0.02 g [IQR, 0.01–0.1] vs 0.03 g [IQR, 0.01–0.28], p = 0.042). Blood pressure control improved at 3 months and 6 months after the intervention. The need for antihypertensive drugs decreased; clinical systolic blood pressure, diastolic blood pressure and 24 hour average systolic blood pressure and diastolic blood pressure decreased. The pulse wave velocity decreased after 3 and 6 months. At the end of follow-up, none of the following adverse events occurred: death, dialysis, myocardial infarction or stroke. Mild lower extremity edema occurred in only one patient. No other side effects occurred.Conclusions:This study showed that lercanidipine can improve renal function in patients undergoing renal artery intervention.

Сравнительная эффективность и переносимость лерканидипина и левовращающего амлодипина у больных гипертонической болезнью в сочетании с абдоминальным ожирением

Целью работы явилось проведение сравнительного исследования клинической эффективности и переносимости S-изомера амлодипина и лерканидипина у больных АГ в сочетании с АО. Показано, что монотерапия S-амлодипином и лерканидипином — это эффективные варианты терапии мягкой и умеренной форм ГБ, в том числе в сочетании с АО. Однако терапия лерканидипином в достоверно большем числе случаев приводит к достижению целевого АД в сравнении с S-амлодипином. Монотерапия лерканидипином приводила к достоверному снижению ИР и уровня МАУ у обследованных больных, в то время как монотерапия S-амлодипином не вызывала достоверной положительной динамики указанных показателей. Обнаружена достоверно меньшая частота развития любых побочных эффектов у больных ГБ с АО под влиянием монотерапии лерканидипином по сравнению с S-амлодипином. Лечение лерканидипином вызывало достоверно меньшую частоту развития отечности нижних конечностей у больных ГБ с АО, чем рацемический амлодипин и S-амлодипин.

Efficacy and tolerability of lercanidipine in patients with hypertension: results of a Phase IV study in general practice

Introduction: Calcium antagonists are very effective drugs, recommended as first-line therapy in hypertension. However, their large use in clinical practice is often limited by a high incidence of peripheral oedema. Calcium antagonists of the third generation, such as lercanidipine, have been shown to be as effective as first- and second-generation calcium antagonists, while showing a better side-effect profile. Objective and methods: The purpose of the present Phase IV study was to investigate the efficacy and tolerability of lercanidipine in a large unselected population of hypertensive patients managed in private practice in Switzerland. A total of 504 physicians participated in this survey and 2199 patients were included. Treatment with lercanidipine was introduced at a dose of 10 mg and titration to 20 mg was optional according to the physician's decision. Evaluations of blood pressure control and tolerability were made after 4 and 8 weeks. Results: The results of the present study show that lercanidipine is an effective and well tolerated antihypertensive agent in newly treated hypertensive patients. In this group of patients, 63% reached the target blood pressure (≤ 140/90 mmHg) with lercanidipine alone. Lercanidipine is also an effective alternative in patients who are insufficiently controlled with another therapy, or in patients not tolerating other calcium channel blockers. Finally, lercanidipine is well-tolerated, with a very low rate of drop-out (1 – 2%) because of adverse events, and a low occurrence of peripheral oedema. Conclusion: Lercanidipine is an effective and well tolerated calcium channel blocker of the third generation. This new calcium antagonist represents a very useful tool to improve blood pressure control in the community.

Lercanidipine in Patients with Chronic Renal Failure: The ZAFRA Study

Objective: The objective was primary to evaluate the safe use of a new calcium channel blocker, lercanidipine, in patients with chronic renal failure (CRF). The secondary objective was to study the protective effect of calcium channel blocker on renal function in CRF patients previously treated with ACE inhibitors or angiotensin receptor blockers. Design and Methods: The study recruited 203 CRF patients (creatinine > 1.4 mg/dL for males, creatinine > 1.2 mg/dL for females, or creatinine clearance < 70 mL/min). All patients were receiving ACE inhibitors (63.4%) or angiotensin II antagonist (36.6%) therapy, but they had higher blood pressure than recommended for CRF (130/85 mmHg). No patients were under diuretic treatment. Patients were clinically evaluated 1, 3, and 6 months after starting treatment with lercanidipine. Samples for urine and blood examination were taken during the examination. When needed, a third drug was added to the treatment, excluding diuretics. Creatinine clearance was measured using 24 h urine collection. Results: 175 patients rendered valuable for the study (age 63.9 ± 11.9 years, 52.9% males and 47.1% females). Blood pressure (BP) significantly decreased from 162 ± 17/93 ± 8.3 mmHg to 132 ± 12/78 ± 6 mmHg. 89.2% of patients showed a significant BP reduction, and 58.1% achieved optimal BP control (< 130/85 mmHg). Seven patients (3.4%) showed untoward effects. Not one case of edema was detected, and the prevalence of adverse effects related to vasodilatation was extremely low (three patients, 1.48%). Plasmatic creatinine did not change (1.9 ± 0.5 baseline versus 1.9 ± 0.6 mg/dL), but creatinine clearance increased at the end visit (41.8 ± 16.0 baseline versus 45.8 ± 18.0 mL/min, p = 0.019). Plasmatic cholesterol also decreased from 221 ± 46 to 211 ± 35 mg/dL (p = 0.001). Conclusions: Lercanidipine showed a high antihypertensive effect in CRF patients. It has a good tolerability profile and showed an interesting effect on plasmatic lipids. An improvement in renal function, measured through creatine clearance, was detected.

Lercanidipine in Patients with Chronic Renal Failure: The ZAFRA Study

Lercanidipine in Patients with Chronic Renal Failure: The ZAFRA Study

Correction of arterial stiffness by calcium channel antagonist lercanidipine in patients with nonsevere fibrosis

Correction of arterial stiffness by calcium channel antagonist lercanidipine in patients with nonsevere fibrosis

Cardiovascular safety of lercanidipine in patients with angina pectoris: a review of six randomized clinical trials

Background: Lercanidipine, a novel lipophilic and vasoselective dihydropyridine calcium antagonist, is an effective antihypertensive drug at dosages of 10 mg once daily in most patients and at dosages of up to 20 mg once daily in nonresponders. Analysis of a large population of hypertensive patients (2,731,000 patient months) has documented that lercanidipine is well tolerated and is not associated with any serious adverse effects. The safety profile of the compound has also been assessed in patients at higher cardiovascular risk due to existing coronary artery disease. Objective: This article reviews the results of 6 randomized, double-blind, controlled trials of lercanidipine to assess the cardiovascular tolerability of this agent in patients with angina. Methods: After a single-dose study of 37 patients, 263 patients with chronic stable angina were treated with lercanidipine at different dosages (5–30 mg/d) for 3 to 12 weeks in 5 other double-blind, placebo- or active-controlled, randomized studies. Safety data from these trials were reviewed. Results: Analysis of heart rate and blood pressure during treatment, both at rest and during effort, indicates that no negative reflex sympathetic activation or undesirable increase in myocardial oxygen consumption should be expected when using lercanidipine. No sudden drop in blood pressure was observed in the studies reviewed. In all studies, a reduction in the percentage of patients with signs of ischemia or angina during exercise tolerance testing was observed after lercanidipine treatment. Conclusions: Data from 6 randomized clinical trials indicate that lercanidipine can be safely used, even in the presence of stable coronary artery disease such as chronic angina.

Acute dose-response, double-blind, placebo-controlled pilot study of lercanidipine in patients with angina pectoris

Abstract Objective The aim of this double-blind, placebo-controlled, parallel-group, dose-response, pilot study was to assess the acute hemodynamic and therapeutic effects of a single dose of lercanidipine in patients with angina pectoris. Background The calcium channel blocker lercanidipine is a new lipophilic, vasoselective dihydropyridine derivative with a slow onset and long duration of action that has been shown to be effective in hypertensive patients at a dosage of 10 to 20 mg/d. Methods Forty-five patients (42 males, 3 females) with chronic stable angina pectoris and angiographically documented coronary artery disease received a single oral dose of lercanidipine 5 mg (n = 7), 10 mg (n = 8), 20 mg (n = 7), 30 mg (n = 7), or 40 mg (n = 8) or of placebo (n = 8). Anti-ischemic and antianginal efficacy was assessed by a bicycle exercise test 3 and 8 hours after dosing. Systolic and diastolic blood pressures and heart rate were assessed both at rest and during exercise. Results Because of the small number of patients and high variability between the groups, no significant difference was seen compared with placebo. Nevertheless, a significant ( P Conclusions Our data indicated that the acute administration of lercanidipine 10 mg to 40 mg in patients with stable exercise-induced angina pectoris caused no unfavorable change in myocardial oxygen consumption and was well tolerated.

Efficacy and Tolerability of Lercanidipine in Patients with Mild to Moderate Essential Hypertension

The objective of this study was to compare the efficacy and tolerability of lercanidipine and slow-release (SR) nifedipine in patients with mild to moderate essential hypertension. After a 3-week placebo run-in, 130 patients aged 18-70 years entered a 16-week double-blind (doubledummy) multicenter study. Patients were randomized to parallel groups receiving either 10 mg lercanidipine once daily or 20 mg nifedipine SR twice daily for 4 weeks. Dose doubling and the addition of 12.5 mg hydrochlorothiazide q.d. (titrated to 25 mg q.d. in non-responders) were allowed in non-responding patients or when diastolic blood pressure (DBP) persisted higher than 90 mm Hg. After 4 weeks of treatment, DBP equally decreased in both the lercanidipine (−9.5 mm Hg) and the nifedipine SR (−10.3 mm Hg) groups. Similar changes were also observed in systolic blood pressure (SBP) after lercanidipine (−11.8 mm Hg) and nifedipine SR (−12.4 mm Hg) treatment. At this time, normalized patients were 50.9% and 52.5% in each group, respectively. Dose doubling and then addition of hydrochlorothiazide was found to be effective in further reducing both DBP and SBP in previously non-responding patients, leading to a high percentage of normalized patients either with lercanidipine (87.5%) or with nifedipine SR (98.1%) treatment. Heart rate did not change, and tolerability was good in both groups. Lercanidipine was found to be as effective as nifedipine SR for lowering blood pressure in hypertensive patients (either alone or in combination with the diuretic hydrochlorothiazide). The low incidence of side effects, including tachycardia, indicates a good tolerability profile for this new drug.

Long-Term (12-Month) Treatment with Lercanidipine in Patients with Mild to Moderate Hypertension

The long-term tolerability and antihypertensive effect of lercanidipine, a new calcium-entry blocker, was evaluated in this open, multicenter study. A total of 355 mild to moderately hypertensive patients (184 men and 171 women) aged 56.1 ± 8.3 years were selected after 2 weeks of wash-out and 3 weeks of placebo run-in and were enrolled for the 1-year treatment phase. The initial dose of lercanidipine 10 mg q.d. was increased every 4 weeks in non-responding patients up to 30 mg q.d. Then, if further BP reduction was needed, a diuretic, an angiotensin-converting enzyme (ACE) inhibitor, or a β-blocker was added to lercanidipine monotherapy. A total of 295 patients completed the study. After 4 weeks of treatment, lercanidipine 10 mg caused a significant reduction of systolic blood pressure (SBP) and diastolic blood pressure (DBP) (−12.2 and −9.7 mm Hg, respectively; p