The Pharmaceutical Journal
Vol 273 No 7315 p304
4 September 2004

This article
Reprint   Photocopy

  Acrobat Reader

News summary

Reassurance over long-term safety of calcium antagonists

Long-acting nifedipine is safe for use by patients with stable angina. This is the main finding of the ACTION trial, published on The Lancet online (August 31).
The trial started in 1996 following concerns about the long-term safety of nifedipine, particularly short acting formulations. It included 7,665 patients randomised to receive nifedipine or placebo on top of their conventional therapy.

The primary end-point was a combination of death, acute myocardial infarction, refractory angina, new heart failure, debilitating stroke and peripheral revascularisation.

With mean follow-up of 4.9 years, there was no difference between the two groups. Study chairman Philip Poole-Wilson, from Imperial College London, emphasises that although the primary end point for efficacy did not differ between treatment groups, “ACTION did not accord with past claims that nifedipine induces myocardial infarction or heart failure”.

Martin Cowie, professor of cardiology at the Royal Brompton Hospital, London, commented to The Journal that ACTION would not change practice but it offered reassurance about safety. “It confirms in a large prospective study that calcium antagonists are safe for patients with cardiovascular disease,” he said.