Browsing by Author "Kubba, S."

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    Beyond Amlodipine—The Case for S-amlodipine as the First Choice Calcium Channel Blocker: An Expert Opinion from India
    (Journal of Indian Medical Association, 2025-04) Hiremath, J; Mohan, JC; Abdullakutty, J; Bansal, S; Dalal, J; Hazra, PK; Rao, S; Shah, VT; Kubba, S.
    Background: Calcium channel blockers (CCBs) have been recommended as the first-line treatment option for the management of hypertension. Amlodipine has been used to treat hypertension over the past 3 decades. However, the chief limitation of amlodipine is pedal edema; it is associated with poor adherence to therapy. Amlodipine is a racemic mixture of two stereoisomers [R(+), S(–)]. Only the S(–) isomer exerts vasodilating action. The R-amlodipine isomer is considered to cause adverse effects. Aim: To understand the place of S-amlodipine and its combinations in the management of hypertension and related cardiovascular (CV) disorders in the real-world setting in India. Methodology: A conclave of nine Indian cardiologists was formed to discuss the place of S-amlodipine in the management of hypertension in their clinical practice. Results: The antihypertensive efficacy of S-amlodipine is comparable to that of amlodipine. S-amlodipine does not cause pedal edema. In fact, switching patients on amlodipine who develop pedal edema to S-amlodipine is helpful in improving patient compliance. However, it would be prudent to initiate treatment with S-amlodipine itself rather than amlodipine, which causes pedal edema. S-amlodipine does not cause gingival hypertrophy, and this improves patient compliance. S-amlodipine consistently lowers blood pressure (BP) across different patient populations such as young, elderly, and patients with CV risk factors. Conclusion: S-amlodipine has antihypertensive, antianginal actions, and pleiotropic effects. S-amlodipine 2.5 mg is found to be equivalent in its efficacy and tolerability when compared to amlodipine 5 mg in the treatment of mild to moderate hypertension.
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    Role of vildagliptin and its combination in type 2 diabetes mellitus management: a knowledge, attitude, and practice survey among Indian healthcare professionals
    (Medip Academy, 2024-08) Kalra, P.; Dharmalingam, M.; Kubba, S.; Bhojwani, H.; Jain, S.
    Background: Type 2 diabetes mellitus (T2DM) is a prevalent condition, with a significant burden in India, affecting approximately 74.2 million individuals. Vildagliptin, a selective dipeptidyl peptidase 4 (DPP-4) inhibitor, is approved globally for monotherapy and combination therapy. Recently, it became available as a generic product, which increased its accessibility to patients. This study aimed to assess the knowledge, attitude, and practice (KAP) regarding vildagliptin and its combination in T2DM management. Methods: A pan-India cross-sectional KAP survey was conducted from February 2022 to March 2023. The survey utilized a specially designed questionnaire focusing on various aspects of vildagliptin treatment. A total of 1,440 healthcare professionals (HCPs) with recognized qualifications and experience in diabetes management participated. Descriptive statistics were employed for data analysis. Results: HCPs reported initiating Vildagliptin monotherapy at an HbA1c 6.5-7.5%, while combination therapy with vildagliptin and metformin at HbA1c 7-8%. Vildagliptin was primarily preferred as an add-on to metformin. Inadequate HbA1c control with existing therapy emerged as the primary trigger for switching to vildagliptin and metformin combination. Treatment-na飗e T2DM patients with HbA1c 1.5% above target and those uncontrolled on metformin monotherapy or dual therapy were reported to benefit most from combination therapy. Combination therapy was reported to result in a glycemic reduction of 1.0-1.5%. HCPs perceived vildagliptin better than other DPP4 inhibitors due to its efficacy in reducing HbA1c and a lower risk of hypoglycemia. Conclusions: The KAP survey highlights the value Indian HCPs place on the effectiveness and tolerability of vildagliptin and their attitudes and practices in its use, highlighting its clinical utility in routine practice.