El papel del clevidipino en el tratamiento antihipertensivo: resultados clínicos

Zuleta-Alarcon, Alix; Castellon-Larios, Karina; Bergese, Sergio D.

doi:10.1016/j.redar.2014.06.006

Cited by 3 publications

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“…Multiple intravenous medications are currently used to control blood pressure (BP) in the perioperative period, and all these drugs have advantages and disadvantages [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Use of Clevidipine: A Systematic Review and Meta-Analysis

et al. 2016

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BackgroundClevidipine is an ultrashort-acting drug for rapid reduction of blood pressure by selectively acting on the L-type Ca2+ channels on arteriolar smooth muscle. The drug’s ultrashort action in reducing the blood pressure is due to its rapid hydrolysis by blood and extravascular tissue esterases, which does not depend on hepato-renal metabolism and excretion. An analysis of the perioperative management of blood pressure should be considered to compare with other intravenous antihypertensive agents.MethodsAnalyses of the available evidence in randomized clinical trials following the PRISMA methodology as well as clinical significance according to the GRADE system were conducted. Placebo versus other antihypertensive drugs studies were included. Statistical assessments were done using the X2 and I2 tests.ResultsClevidipine was more effective in maintaining the blood pressure within pre-specified ranges compared with other antihypertensive drugs (MD, -17.87 CI 95%: -29.02 to -6.72; p = 0.02). The use of Clevidipine versus placebo and rescue antihypertensive intravenous drug showed a clear reduction in rates of treatment failure (RR 0.10; IC 95%; 0.05–0.18; p <0.0001). There was no difference in the incidence of adverse events compared with placebo (RR 1.47; 95% CI 0.89 to 2.43, p = 0.14) and with other antihypertensive drugs (RR 0.78, 95% CI 0.45 to 1.35; p = 0.37). In addition, there was no difference in the incidence of atrial fibrillation (AF) between clevidipine and control groups (RR 1.09, IC del 95%: 0.65 a 1.83; p = 0.73).ConclusionsClevidipine is an ultrafast-acting drug that is highly effective for management of perioperative arterial hypertension. It is devoid of adverse effects associated with the use of other IV antihypertensives. Its favorable pharmacodynamic and pharmacokinetic properties make clevidipine the drug of choice for the management of acute perioperative hypertension. It is important to emphasize the need for further studies with a larger number of patients to confirm these findings and increase the degree of evidence.

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“…Multiple intravenous medications are currently used to control blood pressure (BP) in the perioperative period, and all these drugs have advantages and disadvantages [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Use of Clevidipine: A Systematic Review and Meta-Analysis

et al. 2016

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“…En este volumen, Zuleta-Alarcón et al 27 describen las características farmacocinéticas y farmacodinámicas de un nuevo antagonista de los canales del calcio de tercera generación para uso intravenoso, el clevidipino, así como las evidencias de eficacia y seguridad para la reducción rápida y modulada de la PA en el entorno perioperatorio. Desde una perspectiva de eficacia, si bien el peso de la evidencia recae fundamentalmente en el marco de la cirugía cardíaca, cabe mencionar que las características farmacocinéticas y farmacodinámicas de este medicamento permiten plantear que sería una opción terapéutica adecuada para la reducción precisa y modulada de la PA en otros tipos de cirugías, en las que las excursiones de PAS resultan de difícil manejo, como en la endarterectomía carotídea, el trasplante renal, la neurocirugía y la neurorradiología intervencionista.…”

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