Division of Cardiology, Cook County Health and Hospitals System, 1901 W. Harrison St, Chicago, IL, 60612, USA.
Division of Cardiology, Rush University Medical Center, Chicago, IL, USA.
J Nucl Cardiol. 2018 Feb;25(1):137-149. doi: 10.1007/s12350-017-0960-6. Epub 2017 Jun 26.
Regadenoson is a selective A adenosine receptor agonist that has been approved as a vasodilator stress agent with single-photon emission-computed tomography (SPECT) myocardial perfusion imaging (MPI). Since its approval by the Food and Drug Administration (FDA) in 2008, it has become the most commonly used pharmacologic stress agent with SPECT-MPI. Given that it is predominantly renally excreted, its use in patients with chronic kidney disease has been the subject of active post-marketing clinical research. Until recently, prescribing information regarding the use of regadenoson in patients with end-stage renal disease (ESRD) was not defined in the package insert. Based on accumulating data since its initial approval, the FDA has recently outlined the use of regadenoson in patients with ESRD in a label update on January 17, 2017. In this review, we discuss the evidence leading to the recent label update, focusing on the pharmacokinetics of regadenoson in patients with impaired kidney function, the safety and tolerability of regadenoson in patients with chronic kidney disease and ESRD, and the prognostic value of regadenoson stress MPI in this patient population.
雷卡地诺森是一种选择性 A 腺苷受体激动剂，已被批准作为单光子发射计算机断层扫描（SPECT）心肌灌注成像（MPI）的血管扩张剂应激剂。自 2008 年被美国食品和药物管理局（FDA）批准以来，它已成为最常用的 SPECT-MPI 药理学应激剂。鉴于其主要通过肾脏排泄，因此对慢性肾脏病患者的应用一直是积极的上市后临床研究的主题。直到最近，关于雷卡地诺森在终末期肾病（ESRD）患者中的使用的处方信息在包装插页中并未定义。基于最初批准后的累积数据，FDA 最近在 2017 年 1 月 17 日的标签更新中概述了雷卡地诺森在 ESRD 患者中的使用。在这篇综述中，我们讨论了导致最近标签更新的证据，重点是肾功能受损患者中雷卡地诺森的药代动力学、慢性肾脏病和 ESRD 患者中雷卡地诺森的安全性和耐受性，以及该患者人群中雷卡地诺森应激 MPI 的预后价值。
