Indapamide
| 證據等級: L5 | 預測適應症: 10 個 |
目錄
Indapamide: From Hypertension to Chronic Pulmonary Heart Disease
One-Sentence Summary
Indapamide is a thiazide-like diuretic/antihypertensive agent (per supporting literature in this evidence pack; no formal original-indication record is available). The TxGNN model predicts potential efficacy for Chronic Pulmonary Heart Disease (cor pulmonale), with no registered clinical trials and 3 supporting publications currently identified — evidence for this specific link remains preliminary.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Hypertension (based on supporting literature references; no TFDA/ARTG-approved indication text is available, as the drug is not currently marketed) |
| Predicted New Indication | Chronic Pulmonary Heart Disease |
| TxGNN Prediction Score | 92.97% |
| Evidence Level | L4 |
| Australia Market Status | Not marketed |
| Number of ARTG Entries | 0 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data for indapamide is not available in this evidence pack. Based on the supporting literature, indapamide is a thiazide-like diuretic with established efficacy in hypertension, and its diuretic/antihypertensive action may mechanistically extend to conditions involving right-heart volume overload.
Chronic pulmonary heart disease (cor pulmonale) frequently involves right ventricular failure and fluid retention secondary to chronic lung disease. Diuretic therapy is theoretically capable of relieving this volume overload. The most directly relevant source identified (Krushka et al., 2008) reports that long-term perindopril/indapamide combination (“Noliprel”) therapy in COPD-related cor pulmonale slowed cardiac remodelling, improved right and left ventricular function, and reduced pulmonary artery pressure — but this evidence comes from a fixed combination product rather than indapamide alone, and no trial has tested indapamide specifically for this indication.
The remaining literature is either general background on the hypertension-to-heart-failure continuum, or a case report of indapamide overdose in a COPD patient — evidence of toxicity risk rather than therapeutic benefit. Overall, the mechanistic rationale is plausible but not yet substantiated by dedicated clinical evidence.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 19069455 | 2008 | Review | Klinicheskaia Meditsina | Long-term perindopril/indapamide (“Noliprel”) therapy in COPD-related chronic pulmonary heart disease slowed cardiac remodelling, improved systolic/diastolic right and left ventricular function, and reduced pulmonary artery pressure — reports combination therapy, not indapamide alone. |
| 28711447 | 2017 | Review | JACC: Heart Failure | General review of the progression from chronic hypertension to heart failure via cardiac remodelling (diastolic dysfunction, LV hypertrophy); not specific to indapamide or cor pulmonale. |
| 19623566 | 2009 | Case Report | Pharmacoepidemiology and Drug Safety | Describes an overdose of indapamide, methyldopa and theophylline in an elderly COPD patient, causing prolonged hypotension, marked diuresis and hypokalaemia — a toxicity signal rather than efficacy evidence. |
Australia Market Information
No ARTG entries were identified. Indapamide is currently not marketed in Australia according to the regulatory data in this evidence pack.
Safety Considerations
Please refer to the TGA-approved Product Information (PI) for safety information — no key warnings, contraindications, or drug interaction data were returned for indapamide in this evidence pack (DDI query status: not found).
Note: an unrelated case report identified elsewhere in this evidence pack (PMID 34736431, indexed against a different candidate indication) describes indapamide-induced bilateral choroidal effusion and acute angle-closure glaucoma. While not part of the cor pulmonale evidence base, prescribers should be aware of this reported ocular adverse effect.
Conclusion and Next Steps
Decision: Hold
Rationale: Evidence for indapamide in chronic pulmonary heart disease currently consists of one relevant combination-therapy review, general background literature, and a toxicity case report — no clinical trials or indapamide-specific efficacy data exist. This does not meet the threshold to proceed.
To proceed, the following is needed:
- Indapamide’s original mechanism of action (MOA) and TFDA/PI warnings and contraindications (currently flagged as data gaps, one of which is Blocking for safety screening)
- A study or trial evaluating indapamide monotherapy (not the perindopril/indapamide combination) specifically in cor pulmonale/right heart failure patients
- Confirmation of ARTG registration status if market entry in Australia is being considered
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.