Delving into the Latest Updates on Amezinium Metilsulfate with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

Amezinium Methylsulfate, Amezinium metilsulfate (JAN), 甲硫阿美铵

+ [5]

Target

NET

Action

inhibitors

Mechanism

NET inhibitors(Norepinephrine transporter inhibitors)

Therapeutic Areas

Nervous System DiseasesCardiovascular Diseases

Active Indication

HypotensionHypotension, Orthostatic

Inactive Indication-

Originator Organization

Sumitomo Pharma Co., Ltd.

Active Organization

Sumitomo Pharma Co., Ltd.

Inactive Organization-

License Organization-

Drug Highest PhaseApproved

First Approval Date

Japan (28 Jun 1991),

Hypotension, OrthostaticHypotension

Regulation-

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Structure/Sequence

Molecular FormulaC12H15N3O5S

InChIKeyZEASXVYVFFXULL-UHFFFAOYSA-N

CAS Registry30578-37-1

A 54-year-old male presented with a two-year history of recurrent syncope. Although he was treated with droxidopa and amezinium metilsulfate, his syncope was drug-resistant. Blood tests, cardiac evaluation and brain computed tomography (CT) were unremarkable. As his Schellong test was positive, orthostatic hypotension and syncope were the tentative diagnoses. Upon evaluating the patient neurologically while carefully avoiding syncope induction, mild cerebellar ataxia was observed. However, a brain magnetic resonance imaging (MRI) scan revealed a possible "cross sign" in the pons. Subsequent dopamine transporter single-photon emission computed tomography (DAT-SPECT) showed reduced uptake in the basal ganglia. Based on these findings, a clinical diagnosis of probable multiple system atrophy of the cerebellar type (MSA-C) was made, and treatment with taltirelin hydrate was initiated. This case underscores the importance of considering multiple system atrophy (MSA) in patients with persistent orthostatic hypotension and syncope, even before more obvious neurodegenerative symptoms emerge.

01 Nov 2021·Journal of neurologyQ2 · MEDICINE

Association between neurosarcoidosis with autonomic dysfunction and anti-ganglionic acetylcholine receptor antibodies

Q2 · MEDICINE

Article

Author: Saito, Asami ; Matsuo, Hidenori ; Higuchi, Osamu ; Tanaka, Tomonori ; Koike, Haruki ; Arita, Yukimasa ; Tanaka, Fumiaki ; Nakane, Shunya ; Abiru, Norio ; Maeda, Yasuhiro ; Kunii, Misako ; Tsuiki, Eiko ; Yamaguchi, Naohiro ; Kawano, Hiroaki ; Oishi, Makoto ; Katsuno, Masahisa ; Mukaino, Akihiro ; Tsujino, Akira

Abstract:

Objective:

To determine whether autonomic dysfunction in neurosarcoidosis is associated with anti-ganglionic acetylcholine receptor (gAChR) antibodies, which are detected in autoimmune autonomic ganglionopathy.

Methods:

We retrospectively extracted cases of sarcoidosis from 1787 serum samples of 1,381 patients between 2012 and 2018. Anti-gAChR antibodies against the α3 and β4 subunit were measured by luciferase immunoprecipitation to confirm the clinical features of each case. We summarized literature reviews of neurosarcoidosis with severe dysautonomia to identify relevant clinical features and outcomes.

Results:

We extracted three new cases of neurosarcoidosis with severe dysautonomia, among which two were positive for anti-gAChR antibodies: Case 1 was positive for antibodies against the β4 subunit, and Case 2 was positive for antibodies against both the α3 and β4 subunits. We reviewed the cases of 15 patients with neurosarcoidosis and severe dysautonomia, including the three cases presented herein. Orthostatic hypotension and orthostatic intolerance were the most common symptoms. Among the various types of neuropathy, small fiber neuropathy (SFN) was the most prevalent, with seven of nine cases exhibiting definite SFN. Six of eight cases had impaired postganglionic fibers, of which the present three cases revealed abnormality of 123I-MIBG myocardial scintigraphy. Of the 11 cases, 10 were responsive to immunotherapy, except one seropositive case (Case 2).

Conclusions:

The presence of gAChR antibodies may constitute one of the mechanisms by which dysautonomia arises in neurosarcoidosis.

01 Mar 2016·Cephalalgia : an international journal of headacheQ2 · MEDICINE

Diffuse cerebrovascular dilation: Case report of amezinium metilsulfate-induced reversible cerebral vasoconstriction syndrome

Q2 · MEDICINE

Article

Author: Kobayashi, Makoto

Background:

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headaches with reversible cerebral vasoconstriction, and often precipitated by the postpartum state and vasoactive medications. We describe a case of a patient with RCVS induced by amezinium metilsulfate, a sympathomimetic drug, in whom magnetic resonance angiography (MRA) initially revealed diffusely dilated cerebral arteries.

Case description:

A 34-year-old woman was prescribed amezinium metilsulfate for hypotension. Twelve days later, she suffered from abrupt severe headaches and was referred to our department. She had no neurological deficits; however, MRA revealed diffusely dilated anterior, middle, and posterior cerebral arteries with vasoconstriction. She was tentatively diagnosed with RCVS and successfully treated with verapamil for headache. Nevertheless, follow-up MRAs disclosed widespread segmental vasoconstriction that resolved in two months.

Discussion:

Diffuse cerebrovascular dilation has not been addressed but may be associated with RCVS pathophysiology. In addition, physicians should bear in mind that amezinium metilsulfate can potentially induce RCVS.

100 Deals associated with Amezinium Metilsulfate

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