The effect on heart rate of combining single-dose fingolimod with steady-state atenolol or diltiazem in healthy subjects.

OBJECTIVE: The sphingosine-1-phosphate receptor modulator fingolimod (FTY720) is known to elicit a negative chronotropic effect at treatment initiation that attenuates over time with continued dosing. The authors determined the effect of combining a single dose of fingolimod with steady-state atenol...

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Publicado en:European Journal of Clinical Pharmacology Vol. 64; no. 5; pp. 457 - 464
Autores principales: Kovarik JM, Lu M, Riviere GJ, Barbet I, Maton S, Goldwater DR, Schmouder RL
Formato: clinical trial research Journal Article
Publicado: Springer Nature May2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2008
      vid: 64
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      pub: Springer Nature
      place: New York, New York
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        atl: The effect on heart rate of combining single-dose fingolimod with steady-state atenolol or diltiazem in healthy subjects.
      aug:
        au:
          Kovarik JM
          Lu M
          Riviere GJ
          Barbet I
          Maton S
          Goldwater DR
          Schmouder RL
      sug:
        subj:
          Antihypertensive Agents Pharmacodynamics
          Atenolol Pharmacodynamics
          Diltiazem Pharmacodynamics
          Glycols
          Heart Rate Drug Effects
          Immunosuppressive Agents Pharmacodynamics
          Propylene Glycols Pharmacodynamics
          Adolescence
          Adult
          Antihypertensive Agents Pharmacokinetics
          Atenolol Pharmacokinetics
          Blood Pressure Monitoring, Ambulatory
          Blood Pressure Drug Effects
          Crossover Design
          Diltiazem Pharmacokinetics
          Female
          Glycols Pharmacodynamics
          Glycols Pharmacokinetics
          Immunosuppressive Agents Pharmacokinetics
          Male
          Middle Age
          Pharmacokinetics
          Propylene Glycols Pharmacokinetics
          Receptors, Cell Surface Metabolism
          Single-Blind Studies
          Human
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: OBJECTIVE: The sphingosine-1-phosphate receptor modulator fingolimod (FTY720) is known to elicit a negative chronotropic effect at treatment initiation that attenuates over time with continued dosing. The authors determined the effect of combining a single dose of fingolimod with steady-state atenolol or diltiazem on heart rate and mean arterial pressure. METHODS: In a partially randomized, single-blind, placebo-controlled, three-period, crossover study, 25 healthy subjects received (1) a single oral 5-mg dose of fingolimod, (2) either 50 mg atenolol or 240 mg diltiazem once daily for 5 days, and (3) the antihypertensive for 5 days and a single dose of fingolimod on day 5. Telemetry and pharmacokinetic data were collected. RESULTS: The daytime mean heart rate nadir was 15% lower when fingolimod was combined with atenolol (42 +/- 7 bpm) compared with fingolimod alone (51 +/- 9 bpm) yielding a combination/monotherapy ratio of 0.85 (90%CI, 0.79-0.92). The daytime mean heart rate nadir from fingolimod alone (55 +/- 5 bpm) was not altered when combined with diltiazem (56 +/- 8 bpm) yielding a ratio of 0.99 (0.94-1.05). There was no clinically relevant change in mean arterial pressure when fingolimod was administered with atenolol or diltiazem compared with administration of the drugs alone in normotensive subjects. The pharmacokinetics of the drugs were not altered during coadministration. CONCLUSION: Adding fingolimod to a beta-blocker such as atenolol resulted in a moderately lower mean heart rate nadir compared with fingolimod alone. However, subjects who had a stronger negative chronotropic response to fingolimod alone (nadir < 50 bpm) had minimal or no further reduction in heart rate with the drug combination. Adding fingolimod to a calcium channel blocker such as diltiazem did not further lower the heart rate compared to fingolimod alone.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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