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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

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background. Patients with reactive airways are at risk for adenosine-induced bronchocon-striction, mediated via A2B and/or A3 adenosine receptors.

Methods and Results. To examine the effects of regadenoson, a selective adenosine A2A receptor agonist, on airway resistance, we conducted a randomized, double-blind, placebo-controlled crossover trial in asthmatic patients with a positive adenosine monophosphate challenge test. The mean ratio of the forced expiratory volume in 1 second (FEV1) at each tested time point relative to the baseline FEV1 was significantly higher after treatment with regadenoson compared with placebo from 10 to 60 minutes after treatment. One patient had a substantial but asymptomatic FEV1 reduction (−36.2%) after regadenoson that reversed spontaneously. The most common adverse events with regadenoson were tachycardia (66%), dizziness (53%), headache (45%), and dyspnea (34%). The mean heart rate significantly increased with regadenoson (maximum of +10.4 beats/min) versus placebo.

Conclusions. In this pilot safety study of 48 patients with mild or moderate asthma who had bronchial reactivity to adenosine monophosphate, regadenoson was safe and well tolerated.

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Authors and Affiliations

  1. From the Pulmonology, Heart and Lung Centre, London, England

    Brian R. Leaker DM, MRCP(UK), B. O’Connor MD, FRCP, Trevor T. Hansel MD, FRCPath & Peter J. Barnes DM, DSc, FRCP

  2. Biostatistics, CV Therapeutics, Palo Alto, Calif.

    Lixen Meng MS, MPH

  3. Clinical Research, CV Therapeutics, Palo Alto, Calif.

    Vandana S. Mathur MD, FASN & Hsiao D. Lieu MD

Authors
  1. Brian R. Leaker DM, MRCP(UK)
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  2. B. O’Connor MD, FRCP
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  3. Trevor T. Hansel MD, FRCPath
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  4. Peter J. Barnes DM, DSc, FRCP
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  5. Lixen Meng MS, MPH
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  6. Vandana S. Mathur MD, FASN
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  7. Hsiao D. Lieu MD
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Corresponding author

Correspondence to Vandana S. Mathur MD, FASN.

Additional information

CV Therapeutics provided financial assistance for this study.

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Leaker, B.R., O’Connor, B., Hansel, T.T. 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 15, 329–336 (2008). https://doi.org/10.1016/j.nuclcard.2008.02.009

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  • DOI: https://doi.org/10.1016/j.nuclcard.2008.02.009

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