Utilisation de la nifédipine et de la nicardipine dans le traitement de la menace d’accouchement prématurée : données observationnelles en population

Ray, Camille Le; Maillard, Florie; Carbonne, Bruno; Verspyck, É.; Cabrol, D.; Goffinet, François; Evaprima, pour le groupe

doi:10.1016/j.jgyn.2010.04.004

Cited by 11 publications

(3 citation statements)

References 17 publications

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“…Nifedipine is equally efficacious when compared to atosiban, though the lower cost of nifedipine and the impact on reducing neonatal morbidity often makes it the preferred drug of choice [67]. Other CCBs, such as nicardipine, can be administered intravenously or orally; this flexible route of administration is a benefit over nifedipine, which is only orally or sublingually administered [85]. However, nicardipine may have reduced efficacy in prolonging the duration of pregnancy and may produce more side effects in neonates [67,85].…”

Section: Calcium Channel Blockers (Ccbs): Low Cost and Favorable Safety Profilementioning

confidence: 99%

“…Other CCBs, such as nicardipine, can be administered intravenously or orally; this flexible route of administration is a benefit over nifedipine, which is only orally or sublingually administered [85]. However, nicardipine may have reduced efficacy in prolonging the duration of pregnancy and may produce more side effects in neonates [67,85]. Though nifedipine is not FDA-approved for tocolysis, numerous meta-analyses have shown that CCBs may sometimes effectively delay PTB by up to 7 days, a significant increase in the extent of PTB delay when compared with the 24 h or 48 h delay conferred by most other therapeutics [59,86].…”

Section: Calcium Channel Blockers (Ccbs): Low Cost and Favorable Safety Profilementioning

confidence: 99%

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Landscape of Preterm Birth Therapeutics and a Path Forward

Coler

Shynlova

Boros-Rausch

et al. 2021

JCM

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Preterm birth (PTB) remains the leading cause of infant morbidity and mortality. Despite 50 years of research, therapeutic options are limited and many lack clear efficacy. Tocolytic agents are drugs that briefly delay PTB, typically to allow antenatal corticosteroid administration for accelerating fetal lung maturity or to transfer patients to high-level care facilities. Globally, there is an unmet need for better tocolytic agents, particularly in low- and middle-income countries. Although most tocolytics, such as betamimetics and indomethacin, suppress downstream mediators of the parturition pathway, newer therapeutics are being designed to selectively target inflammatory checkpoints with the goal of providing broader and more effective tocolysis. However, the relatively small market for new PTB therapeutics and formidable regulatory hurdles have led to minimal pharmaceutical interest and a stagnant drug pipeline. In this review, we present the current landscape of PTB therapeutics, assessing the history of drug development, mechanisms of action, adverse effects, and the updated literature on drug efficacy. We also review the regulatory hurdles and other obstacles impairing novel tocolytic development. Ultimately, we present possible steps to expedite drug development and meet the growing need for effective preterm birth therapeutics.

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Section: Calcium Channel Blockers (Ccbs): Low Cost and Favorable Safety Profilementioning

confidence: 99%

Section: Calcium Channel Blockers (Ccbs): Low Cost and Favorable Safety Profilementioning

confidence: 99%

Landscape of Preterm Birth Therapeutics and a Path Forward

Coler

Shynlova

Boros-Rausch

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…However, intravenous nicardipine does not increase the duration of pregnancy in comparison with oral nifedipine. The median duration between treatment for PTB and delivery was significantly longer when nifedipine was used [44]. Oral nicardipine is additionally an effective and well-tolerated tocolytic agent.…”

Section: The Efficacy Of Ccbs Against Ptbmentioning

confidence: 99%

Calcium Channel Blockers as Tocolytics: Principles of Their Actions, Adverse Effects and Therapeutic Combinations

Gáspár

Hajagos-Tóth

2013

Pharmaceuticals

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Dihydropyridine Ca2+ channel blockers (CCBs) are widely accepted in the treatment of premature labour. Their mechanism of action in tocolysis involves the blockade of L-type Ca2+ channels, influenced by the Ca2+-activated K+ channels, beta-adrenergic receptors (β-ARs) and sexual hormones. In clinical practice, most experience has been gained with the use of nifedipine, whose efficacy is superior or comparable to those of β-agonists and oxytocin antagonists. Additionally, it has a favourable adverse effect profile as compared with the majority of other tocolytics. The most frequent and well-tolerated side-effects of CCBs are tachycardia, headache and hypotension. In tocolytic therapy efforts are currently being made to find combinations of tocolytic agents that yield better therapeutic action. The available human and animal studies suggest that the combination of CCBs with β-AR agonists is beneficial, although such combinations can pose risk of pulmonary oedema in multiple pregnancies and maternal cardiovascular diseases. Preclinical data indicate the potential benefit of combinations of CCBs and oxytocin antagonists. However, the combinations of CCBs with progesterone or cyclooxygenase inhibitors may decrease their efficacy. The CCBs are likely to remain one of the most important groups of drugs for the rapid inhibition of premature uterine contractions. Their significance may be magnified by further clinical studies on their combined use for tocolysis.

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Off-label use of nicardipine as tocolytic and acute pulmonary oedema: a post-marketing analysis of adverse drug reaction reports in EudraVigilance

Melis

Cupelli

Sottosanti

et al. 2015

Pharmacoepidemiol Drug Saf

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A potentially causal association between APO and off-label use of nicardipine as tocolytic has been detected during a periodic signal detection activity. The Pharmacovigilance Risk Assessment Committee confirmed our findings, recommending an update of the summary of the product characteristics for medicines containing nicardipine for both intravenous and oral formulations. Then European Medicines Agency reaffirmed that nicardipine use in other indications is no longer recommended.

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Utilisation de la nifédipine et de la nicardipine dans le traitement de la menace d’accouchement prématurée : données observationnelles en population

Abstract: Nicardipine is the first choice for French obstetricians in management of severe threatened preterm delivery. However, intravenous nicardipine does not increase gestational duration in comparison with oral nifedipine.

Cited by 11 publications

References 17 publications

Landscape of Preterm Birth Therapeutics and a Path Forward

Landscape of Preterm Birth Therapeutics and a Path Forward

Calcium Channel Blockers as Tocolytics: Principles of Their Actions, Adverse Effects and Therapeutic Combinations

Off-label use of nicardipine as tocolytic and acute pulmonary oedema: a post-marketing analysis of adverse drug reaction reports in EudraVigilance

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