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. May-Jun 2008;15(3):329-36. doi: 10.1016/j.nuclcard.2008.02.009. Epub 2008 Apr 14.

Abstract

Background: Patients with reactive airways are at risk for adenosine-induced bronchoconstriction, mediated via A(2B) and/or A(3) adenosine receptors.

Methods and results: To examine the effects of regadenoson, a selective adenosine A(2A) 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 (FEV(1)) at each tested time point relative to the baseline FEV(1) was significantly higher after treatment with regadenoson compared with placebo from 10 to 60 minutes after treatment. One patient had a substantial but asymptomatic FEV(1) 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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine A2 Receptor Antagonists*
  • Adult
  • Asthma / complications
  • Asthma / diagnosis*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnosis*
  • Double-Blind Method
  • Exercise Test / adverse effects*
  • Exercise Test / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Placebo Effect
  • Purines / administration & dosage
  • Purines / adverse effects*
  • Pyrazoles / administration & dosage
  • Pyrazoles / adverse effects*
  • Respiration Disorders / chemically induced*
  • Respiration Disorders / diagnosis
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Adenosine A2 Receptor Antagonists
  • Purines
  • Pyrazoles
  • regadenoson