Comparative study of the safety of regadenoson between patients with mild/moderate chronic obstructive pulmonary disease and asthma.

Abstract

PURPOSE:

To compare the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise, between subjects with mild/moderate chronic obstructive pulmonary disease (COPD) and asthma referred for myocardial perfusion imaging (MPI).

METHODS:

We studied 116 patients, of whom 67 had COPD and 49 asthma (62 % men, mean age 68.3 ± 11.3 years, range 31 - 87 years). Patient demographics, past medical history, medications, clinical symptoms during stress and changes in blood pressure (BP) and heart rate (HR) were evaluated.

RESULTS:

Both groups were comparable with regard to hypertension, dyslipidaemia, diabetes and medications with the exception of a higher rate of use of anticholinergics in patients with COPD and of antileukotrienes in asthmatics (58.2 % vs. 28.6 % and 1.5 % vs. 14.3 %, respectively; all p < 0.01). There was a higher incidence of dyspnoea in COPD patients and of headache and feeling hot in asthmatic patients (40.3 % vs. 22.4 %, 6 % vs. 18.4 % and 10.4 % vs. 26.5 %, respectively; all p < 0.05). Although there was no difference in the incidence of other adverse events, we observed a higher frequency in asthmatics of flushing, dry mouth, sweating and fatigue (1.5 % vs. 6.1 %, 14.9 % vs. 24.5 %, 0 % vs. 4.1 % and 37.3 % vs. 49 %, respectively). Adverse events were self-limiting, except in three patients who suffered persistent dyspnoea (2 of 67 COPD patients; 1 of 49 asthma patients) requiring theophylline administration. We observed no significant changes in BP among either group, but there was a tendency towards a higher increase in systolic BP in COPD patients following regadenoson administration (148.3 ± 27.6 vs. 154.6 ± 31.0 mmHg, p = 0.056).

CONCLUSION:

This study showed a good safety profile in our series of COPD and asthma patients undergoing MPI. Regadenoson was well tolerated by all patients, with dyspnoea, headache and feeling hot showing differences between groups.

• Authors: Carlos Salgado Garcia, Carlos Salgado Garcia, Amelia Jimenez Heffernan, Amelia Jimenez Heffernan, Elena Sanchez de Mora, Carlos Ramos Font, Juana Lopez Martin, Francisco Rivera de los Santos, Ignacio Ynfante Milá
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 41 Issue 1 Pg. 119-25 (Jan 2014) ISSN: 1619-7089 [Electronic] Germany
• PMID: 23857459 (Publication Type: Comparative Study, Journal Article, Observational Study)

Chemical References

• Purines
• Pyrazoles
• regadenoson

Topics

• Adult
• Aged
• Aged, 80 and over
• Asthma (drug therapy, physiopathology)
• Blood Pressure (drug effects)
• Exercise Test
• Female
• Heart Rate (drug effects)
• Humans
• Male
• Middle Aged
• Pulmonary Disease, Chronic Obstructive (drug therapy, physiopathology)
• Purines (adverse effects, therapeutic use)
• Pyrazoles (adverse effects, therapeutic use)
• Safety
• Stress, Physiological (drug effects)