Skip to main content
Top
Published in: Journal of Nuclear Cardiology 4/2012

Open Access 01-08-2012 | Original Article

A randomized, double-blind, placebo-controlled study assessing the safety and tolerability of regadenoson in subjects with asthma or chronic obstructive pulmonary disease

Authors: Bruce M. Prenner, MD, Stan Bukofzer, MBBCh, MMed (Int), Sarah Behm, BS, Kathleen Feaheny, MS, Bruce E. McNutt, MD

Published in: Journal of Nuclear Cardiology | Issue 4/2012

Login to get access

Abstract

Background

Adenosine receptor stress agents for myocardial perfusion imaging (MPI) may cause A2B and/or A3 receptor-mediated bronchoconstriction, of particular concern to physicians testing patients with asthma or chronic obstructive pulmonary disease (COPD).

Methods

A Phase 4, randomized, double-blind study (NCT00862641) assessed the safety of the selective A2A receptor agonist, regadenoson, compared with placebo in subjects with asthma or COPD who represented likely candidates for MPI.

Results

Overall, 356 and 176 subjects with asthma and 316 and 151 subjects with COPD received regadenoson and placebo, respectively. The percentage of subjects experiencing a >15% decrease in FEV1 from baseline to any assessment up to 24 hours post-baseline was not statistically significantly different between the regadenoson and the placebo groups in the asthma or COPD stratum. Dyspnea, the most frequent respiratory adverse event, occurred with higher incidence (P < .0001) in the regadenoson group than the placebo group in the asthma (10.7% vs 1.1%) and COPD (18.0% vs 2.6%) strata. No subjects experienced severe bronchoconstriction, although the occurrence of such reactions with adenosine receptor agonists cannot be ruled out, such that caution is advised.

Conclusions

This information may be helpful to physicians selecting a pharmacologic stress agent for MPI in patients with asthma or COPD.
Literature
1.
go back to reference Henzlova MJ, Cerqueira MD, Taillefer R, Mahmarian JJ, Yao SS, Quality Assurance Committee of the American Society of Nuclear Cardiology. Stress protocols and tracers. J Nucl Cardiol 2009. doi:10.1007/s12350-009-9062-4. Henzlova MJ, Cerqueira MD, Taillefer R, Mahmarian JJ, Yao SS, Quality Assurance Committee of the American Society of Nuclear Cardiology. Stress protocols and tracers. J Nucl Cardiol 2009. doi:10.​1007/​s12350-009-9062-4.
2.
go back to reference Belardinelli L, Shryock JC, Snowdy S, et al. The A2A adenosine receptor mediates coronary vasodilation. J Pharmacol Exp Ther 1998;284:1066-73.PubMed Belardinelli L, Shryock JC, Snowdy S, et al. The A2A adenosine receptor mediates coronary vasodilation. J Pharmacol Exp Ther 1998;284:1066-73.PubMed
3.
go back to reference Cerqueira MD. Advances in pharmacologic agents in imaging: New A2A receptor agonists. Curr Cardiol Rep 2006;8:119-22.PubMedCrossRef Cerqueira MD. Advances in pharmacologic agents in imaging: New A2A receptor agonists. Curr Cardiol Rep 2006;8:119-22.PubMedCrossRef
4.
go back to reference Gao Z, Li Z, Baker SP, et al. Novel short-acting A2A adenosine receptor agonists for coronary vasodilation: Inverse relationship between affinity and duration of action of A2A agonists. J Pharmacol Exp Ther 2001;298:209-18.PubMed Gao Z, Li Z, Baker SP, et al. Novel short-acting A2A adenosine receptor agonists for coronary vasodilation: Inverse relationship between affinity and duration of action of A2A agonists. J Pharmacol Exp Ther 2001;298:209-18.PubMed
5.
go back to reference Leaker BR, O’Connor B, Hansel TT, et al. Safety of regadenoson, an adenosine A2A receptor agonist for myocardial perfusion imaging, in mild asthma and moderate asthma patients: A randomized, double-blind, placebo-controlled trial. J Nucl Cardiol 2008;15:329-36.PubMedCrossRef Leaker BR, O’Connor B, Hansel TT, et al. Safety of regadenoson, an adenosine A2A receptor agonist for myocardial perfusion imaging, in mild asthma and moderate asthma patients: A randomized, double-blind, placebo-controlled trial. J Nucl Cardiol 2008;15:329-36.PubMedCrossRef
6.
go back to reference Thomas GS, Tammelin BR, Schiffman GL, et al. Safety of regadenoson, a selective adenosine A2A agonist, in patients with chronic obstructive pulmonary disease: A randomized, double-blind, placebo-controlled trial (RegCOPD trial). J Nucl Cardiol 2008;15:319-28.PubMedCrossRef Thomas GS, Tammelin BR, Schiffman GL, et al. Safety of regadenoson, a selective adenosine A2A agonist, in patients with chronic obstructive pulmonary disease: A randomized, double-blind, placebo-controlled trial (RegCOPD trial). J Nucl Cardiol 2008;15:319-28.PubMedCrossRef
8.
go back to reference Crapo RO, Casaburi R, Coates AL, et al. Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 2000;161:309-29.PubMed Crapo RO, Casaburi R, Coates AL, et al. Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 2000;161:309-29.PubMed
12.
go back to reference Cerqueira MD, Nguyen P, Staehr P, Underwood SR, Iskandrian AE. Effects of age, gender, obesity, and diabetes on the efficacy and safety of the selective A2A agonist regadenoson versus adenosine in myocardial perfusion imaging integrated ADVANCE-MPI trial results. JACC Cardiovasc Imaging 2008;1:307-16.PubMedCrossRef Cerqueira MD, Nguyen P, Staehr P, Underwood SR, Iskandrian AE. Effects of age, gender, obesity, and diabetes on the efficacy and safety of the selective A2A agonist regadenoson versus adenosine in myocardial perfusion imaging integrated ADVANCE-MPI trial results. JACC Cardiovasc Imaging 2008;1:307-16.PubMedCrossRef
13.
go back to reference Hendel RC, Bateman TM, Cerqueira MD, et al. Initial clinical experience with regadenoson, a novel selective A2A agonist for pharmacologic stress single-photon emission computed tomography myocardial perfusion imaging. J Am Coll Cardiol 2005;46:2069-75.PubMedCrossRef Hendel RC, Bateman TM, Cerqueira MD, et al. Initial clinical experience with regadenoson, a novel selective A2A agonist for pharmacologic stress single-photon emission computed tomography myocardial perfusion imaging. J Am Coll Cardiol 2005;46:2069-75.PubMedCrossRef
14.
go back to reference Iskandrian AE, Bateman TM, Belardinelli L, et al. Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: Results of the ADVANCE phase 3 multicenter international trial. J Nucl Cardiol 2007;14:645-58.PubMedCrossRef Iskandrian AE, Bateman TM, Belardinelli L, et al. Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: Results of the ADVANCE phase 3 multicenter international trial. J Nucl Cardiol 2007;14:645-58.PubMedCrossRef
15.
go back to reference Cerqueira MD, Verani MS, Schwaiger M, Heo J, Iskandrian AS. Safety profile of adenosine stress perfusion imaging: Results from the Adenoscan Multicenter Trial Registry. J Am Coll Cardiol 1994;23:384-9.PubMedCrossRef Cerqueira MD, Verani MS, Schwaiger M, Heo J, Iskandrian AS. Safety profile of adenosine stress perfusion imaging: Results from the Adenoscan Multicenter Trial Registry. J Am Coll Cardiol 1994;23:384-9.PubMedCrossRef
16.
go back to reference Lette J, Tatum JL, Fraser S, et al. Safety of dipyridamole testing in 73,806 patients: The Multicenter Dipyridamole Safety Study. J Nucl Cardiol 1995;2:3-17.PubMedCrossRef Lette J, Tatum JL, Fraser S, et al. Safety of dipyridamole testing in 73,806 patients: The Multicenter Dipyridamole Safety Study. J Nucl Cardiol 1995;2:3-17.PubMedCrossRef
Metadata
Title
A randomized, double-blind, placebo-controlled study assessing the safety and tolerability of regadenoson in subjects with asthma or chronic obstructive pulmonary disease
Authors
Bruce M. Prenner, MD
Stan Bukofzer, MBBCh, MMed (Int)
Sarah Behm, BS
Kathleen Feaheny, MS
Bruce E. McNutt, MD
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Journal of Nuclear Cardiology / Issue 4/2012
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-012-9547-4

Other articles of this Issue 4/2012

Journal of Nuclear Cardiology 4/2012 Go to the issue