Journal
EXPERT OPINION ON PHARMACOTHERAPY
Volume 10, Issue 2, Pages 311-322Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14656560802682213
Keywords
adenosine; chronic kidney disease; heart failure; rolofylline
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Funding
- Merck, Inc [KW-3902]
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Background: Co-existent cardiac and renal dysfunction is increasingly recognized as both a predictor and mediator of poor outcomes in patients with advanced heart failure. Novel therapies, including adenosine receptor antagonists, are currently under development for the treatment of 'cardiorenal syndrome'. Objectives: To review the pathophysiologic rationale for using rolofylline, a selective adenosine 1 receptor antagonist, in patients with cardiorenal syndrome; and to provide a critical overview of safety and efficacy data from clinical studies. Methods: We reviewed published data on the pharmacology of rolofylline, and used this to inform a comprehensive summary of preclinical and clinical trials. Cardiac and renal effects, and safety data with a particular reference to seizures, are highlighted. Results/conclusion: Rolofylline facilitates diuresis and preserves renal function in patients with acute decompensated heart failure and renal dysfunction. Pilot data also suggest beneficial effects on symptoms and short-term outcomes. The risk of seizures may be minimized by excluding high-risk patients.
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