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Title: Further Investigation Needed Into Beneficial and Harmful Effects of Succinobucol
URL: http://www.pslgroup.com/dg/221D16.htm
Doctor's Guide
May 22, 2008

NEW YORK -- May 22, 2008 -- Researchers have concluded that succinobucol should not be used for treating patients with acute coronary syndromes or for treating or preventing diabetes until a number of both beneficial and harmful outcomes connected with its use have been further investigated. These study conclusions are presented in this week's Diabetes Special Issue of The Lancet.

The antioxidant drug probucol has been shown to reduce atherosclerosis. Succinobucol is closely related to probucol with greater antioxidant strength and anti-inflammatory properties. Jean-Claude Tardif, MD, Montreal Heart Institute, University of Montreal, Montreal, Ontario, and colleagues conducted a randomised, controlled trial to test the effects of succinobucol on cardiovascular outcomes in patients with recent acute coronary syndromes already managed with conventional treatments.

A total of 6,144 patients were randomly assigned to receive either succinobucol (3,078) or placebo (3,066). The primary endpoint was the composite of time to first occurrence of cardiovascular death, resuscitated cardiac arrest, heart attack, stroke, unstable angina, or coronary revascularisation. While the researchers found no difference between succinobucol and placebo for the primary endpoint, the composite secondary endpoint of cardiovascular death, cardiac arrest, heart attack, or stroke occurred in 19% fewer patients in the succinobucol group compared with the placebo group. The tertiary endpoint of new-onset diabetes developed in fewer patients without diabetes at baseline in the succinobucol group (30) compared with the placebo group (82) -- a relative difference of 63%.

New-onset atrial fibrillation occurred almost twice as frequently in the succinobucol group compared with placebo, and more patients in the succinobucol group reported bleeding episodes or anaemia as serious adverse events. Relative to treatment with placebo, succinobucol increased low-density lipoprotein cholesterol and systolic blood pressure, and decreased high-density lipoprotein cholesterol. Glycated haemoglobin was significantly improved by succinobucol.

The findings led the authors to conclude: "Although succinobucol had no effect on the primary endpoint, changes in the rates of other clinical outcomes -- both beneficial and harmful -- will need to be further assessed before succinobucol is used in patients with atherosclerosis or as an antidiabetic agent."


SOURCE: The Lancet

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