Ramipril for the Prevention and Treatment of Cardiovascular Disease

Vuong, April D; Annis, Laura G.

doi:10.1345/aph.1c262

Cited by 14 publications

(8 citation statements)

References 41 publications

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“…Ramipril is the only ACE inhibitor that is currently approved for the prevention of cardiovascular events in high risk patients based on the results of the HOPE trial. 13 It was demonstrated that in the normotensive patients, cardiovascular benefi ts of ramipril are independent of its blood pressure lowering effects. 14 ACE inhibitors also do not have lipid-lowering properties.…”

Section: Discussionmentioning

confidence: 99%

Circulating Markers Reflect Both Anti- and Pro-Atherogenic Drug Effects in ApoE-Deficient Mice

Liao

McCall²,

Cox

et al. 2008

Biomark�Insights

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Background: Current drug therapy of atherosclerosis is focused on treatment of major risk factors, e.g. hypercholesterolemia while in the future direct disease modifi cation might provide additional benefi ts. However, development of medicines targeting vascular wall disease is complicated by the lack of reliable biomarkers. In this study, we took a novel approach to identify circulating biomarkers indicative of drug effi cacy by reducing the complexity of the in vivo system to the level where neither disease progression nor drug treatment was associated with the changes in plasma cholesterol.

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Section: Discussionmentioning

confidence: 99%

Circulating Markers Reflect Both Anti- and Pro-Atherogenic Drug Effects in ApoE-Deficient Mice

Liao

McCall²,

Cox

et al. 2008

Biomark�Insights

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“…[6] We did a systematic review and meta-analysis to estimate efficacy of ramipril. The efficacy on stroke, acute myocardial infarction, heart failure exacerbation and CVD death ( Table 1) [7][8][9][10][11][12][13][14][15][16][17][18][19] was pooled from four randomized controlled trials: the Heart Outcomes Prevention Evaluation (HOPE) study, [7] HOPE study extension (HOPE-TOO), [8] Acute Infarction Ramipril Efficacy (AIRE) [9] and Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial. [10] Other transition probabilities in the model were derived from literature as shown in Table 1.…”

Section: Model Inputsmentioning

confidence: 99%

“…Hypertension Hypertension --Stroke 0.0075 (0.0059-0.0092) 0.0084 (0.0067-0.0103) [7][8][9][10] AMI 0.0213 (0.0187-0.0242) 0.0251 (0.0222-0.0281) [7][8][9][10] HF exacerbation 0.0179 (0.0155-0.0205) 0.0214 (0.0188-0.0243) [7,9,10] CVD death 0.0124 (0.0105-0.0148) 0.0142 (0.0120-0.0166) [7,8,10] Stroke Hypertension 0.1000 0.1000 [11] Post-stroke --CVD death 0.0424 0.0424 [12] AMI Post-AMI --HF 0.0695 0.0695 [13] CVD death 0.0732 0.0732 [14] HF exacerbation HF --CVD death 0.0603 0.0603 [13] Post-AMI Post-AMI --AMI 0.0692 0.0692 [9] CVD death 0.0257 0.0257 [15] HF HF --HF exacerbation 0.0076 0.0076 [7] CVD death 0.0400 0.0400 [16,17] Post-stroke Post-stroke --Stroke 0.0952 0.0952 [12] CVD death 0.0119 0.0119 [18] CVD death CVD death 1.000 1.000…”

Section: Treatment No Treatmentmentioning

confidence: 99%

Societal monetary benefits of pharmaceutical innovation: the case of ramipril in Canada

Thanh

Chuck

Öhinmaa

et al. 2013

Journal of Pharmaceutical Health Services Research

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Objectives To estimate the monetary benefits of ramipril and its distribution over time among four beneficiaries in Canada: the drug developing manufacturer, generic manufacturers, the healthcare sector and employment sectors. Methods Monetary benefits to developing and generic manufacturers were defined as the profits from the drug. A dynamic Markov model was used to estimate monetary benefits to the healthcare and employment sectors in terms of cost avoidance associated with prevented cardiovascular events, including stroke, myocardial infarction and heart failure, and lost productivity due to disability and premature death in the working population. Key findings Cumulative monetary benefits of ramipril over 18 years (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011) were estimated at CA$3.9 billion, of which the developing manufacturer accounted for 41%, generic manufacturers 4%, the healthcare sector 40% and employment sectors 15%. The benefits for the developing manufacturer were dominant before, but dramatically decreased after, the patent period. Benefits for the healthcare sector started to decrease from 2007, corresponding to the decreasing population taking ramipril during the same period. Higher compliance or efficacy lead to larger benefits for the healthcare and employment sectors, whereas monetary benefits for manufacturers were unchanged. Conclusion Societal monetary benefits of ramipril are distributed differently for the four beneficiaries and over time. Patent, compliance and efficacy play a vital role in the determination of the benefits. High pricing of generic drugs probably makes the benefits to the healthcare and employment sectors lower than expected because that most likely influences some patients to discontinue or switch to alternative drugs.

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“…In general, ramipril exerts its effects through actions in renin-angiotensin-aldosterone system (RAS). It inhibits the conversion of angiotensin I to angiotensin II through actions of ACE, thus decreasing the vasoconstriction, sympathetic activation, and trophic changes in the heart and blood vessels that angiotensin produces (Smith and Ball, 2000;Vuong and Annis, 2003).…”

Section: Introductionmentioning

confidence: 99%

“…After oral administration, 60% of the dose is found in the urine and 40% is found in the feces. The effective half-life for accumulation of ramiprilat is 13 to 17 hours after daily doses of ramipril 5 to 10 mg (Smith and Ball, 2000; Vuong and Annis, 2003).…”

Section: Introductionmentioning

confidence: 99%

Comparative Bioavailability Study of Two Ramipril Tablet Formulations in Indonesian Healthy Volunteers

Harahap¹,

Sasongko²,

Prasaja³

et al. 2009

JBABM

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To compare the bioavailability of two ramipril tablet formulations-10 mg Prohytens ® tablets as test formulation and 10 mg Triatec ® tablets as reference formulation. Methods A single-dosed, open-label, randomized two-way crossover design under fasting period with two weeks wash out period was evaluated in 24 subjects. For the analysis of pharmacokinetic properties, the blood samples were drawn taken up to 72 hours after dosing. Plasma concentration of ramipril and ramiprilat were determined using liquid chromatography-tandem mass spectrometry method with TurboIonSpray mode. Pharmacokinetic parameters AUC 0-t, AUC 0-∞ and C max were tested for bioequivalence after log-transformation of data and ratios of t max were evaluated non-parametrically. Results The point estimates and 90% confidence intervals (CI) for AUC 0-t, AUC 0-∞ and C max for ramipril were 93.21% (85.67-101.41%), 93.45% (85.88-101.69%), 94.02% (80.09-110.38%) and for ramiprilat were 92.26% (87.76-96.99%), 94.59% (89.71-99.73%) and 91.55% (84.88-98.74%). Conclusion These results indicated that the two formulations of ramipril were bioequivalent and thus may be prescribed interchangeably.

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Ramipril for the Prevention and Treatment of Cardiovascular Disease

Cited by 14 publications

References 41 publications

Circulating Markers Reflect Both Anti- and Pro-Atherogenic Drug Effects in ApoE-Deficient Mice

Circulating Markers Reflect Both Anti- and Pro-Atherogenic Drug Effects in ApoE-Deficient Mice

Societal monetary benefits of pharmaceutical innovation: the case of ramipril in Canada

Comparative Bioavailability Study of Two Ramipril Tablet Formulations in Indonesian Healthy Volunteers

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