Evaluation of Xuefu Zhuyu Oral Solution as Add-on Therapy for Stable Angina
Overview
In a multicenter randomized controlled trial, Xuefu Zhuyu oral liquid (XZOL) significantly reduced angina pain intensity and the need for rescue nitroglycerin in patients with stable angina over 12 weeks compared to placebo. The beneficial effects persisted at 24 weeks, with a comparable safety profile between groups.
Background
Stable angina (SA) is a prevalent condition characterized by myocardial ischemia causing chest pain and disability, with substantial residual symptoms despite standard therapies. Conventional antianginal treatments have limitations including incomplete symptom control and adverse effects. Traditional Chinese Medicine, particularly Xuefu Zhuyu oral liquid (XZOL), has been used for SA in China, but high-quality evidence supporting its efficacy and safety has been lacking. This trial aimed to rigorously evaluate XZOL as an adjunctive therapy in patients with stable angina.
Data Highlights
Outcome
XZOL Group (n=74)
Placebo Group (n=74)
Adjusted Mean Difference (95% CI)
P Value
Change in VAS Pain Score at Week 12
Significant reduction
Less reduction
–0.63 (–1.12 to –0.14)
0.012
Change in VAS Pain Score at Week 24
Maintained reduction
Less reduction
–0.47 (–0.94 to –0.002)
0.049
Use of Rescue Nitroglycerin at Week 12
2.7%
13.5%
Not reported
0.016
Use of Rescue Nitroglycerin at Week 24
2.7%
12.2%
Not reported
0.029
Adverse Events
Comparable incidence
Comparable incidence
Not reported
Not significant
Key Findings
XZOL adjunctive therapy led to a statistically significant reduction in angina pain intensity at 12 weeks compared to placebo (adjusted mean difference –0.63 on VAS, P=0.012).
The reduction in angina pain was sustained at 24 weeks follow-up (adjusted mean difference –0.47, P=0.049).
Patients receiving XZOL used rescue nitroglycerin significantly less at both 12 weeks (2.7% vs. 13.5%, P=0.016) and 24 weeks (2.7% vs. 12.2%, P=0.029).
The safety profile of XZOL was favorable, with adverse event rates comparable to placebo.
The trial was rigorously designed as a multicenter, double-blind, randomized, placebo-controlled study, enhancing the reliability of findings.
Clinical Implications
XZOL may be considered as a safe and effective adjunctive treatment for patients with stable angina who continue to experience symptoms despite standard therapy. Its use could reduce angina pain intensity and decrease reliance on rescue nitroglycerin, potentially improving patient quality of life. Clinicians should weigh these benefits alongside current guideline-directed therapies when managing stable angina.
Conclusion
This well-designed trial provides robust evidence that Xuefu Zhuyu oral liquid is an effective and safe add-on therapy for stable angina, reducing symptom burden and rescue medication use. These findings support its integration into comprehensive management strategies for stable angina.
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