RESUMO
Background: Ranolazine is an antianginal drug reported to have hypoglycaemic effects. Objectives: To assess the effect of ranolazine versus placebo on glycaemic control for adults with and without diabetes. Methods: A systematic search of seven databases was conducted to identify all randomised controlled trials that compared the effect of ranolazine versus placebo on haemoglobin A1c (HbA1c) and/or fasting plasma glucose (FPG) and/or incidence of hypoglycaemia. We used mean differences in HbA1c and FPG to express intervention effect estimates and analysed the data with random-effects model for meta-analyses using Revman 5.3. Results: We identified seven trials including 6543 subjects to assess the effect of ranolazine on HbA1c and/or FPG. A separate trial that included 944 subjects was included to assess the effect of ranolazine on hypoglycaemia. The change in HbA1c for all patients was -0.36% (95% CI -0.57% to -0.15%; p=0.0004, I2=78%). In patients with diabetes, the change in HbA1c was -0.41% (95% CI -0.58% to -0.25%; p<0.00001, I2=65%). There was no significant difference in FPG between ranolazine and placebo groups (-2.58 mmol/L, 95% CI -7.02 to 1.85; p=0.25; I2=49%) or incidence of hypoglycaemia between ranolazine and placebo groups (OR 1.70, 95% CI 0.89 to 3.26; p=0.61, I2=0%). Conclusions: Our meta-analytic findings support the fact that ranolazine improves HbA1c without increasing the risk of hypoglycaemia. It therefore has a potential of having an additional benefit of improving glycaemic control in patients with chronic stable angina and diabetes.