Evidence map›Paper›PMID 41357360›Full record

ArticleCurrent therapeutic research, clinical and experimental2025

Pharmacodynamics, Safety, and Tolerability of Pyridostigmine Bromide in Heart Failure.

Randal Goldberg, Lucy Norcliffe-Kaufmann, Horacio Kaufmann, Ikoa Jeschke-Lopez, Yu Guo, Judy Zhong, Kenneth I Berger, Roberta M Goldring, David S Goldstein, Carey Pope and 4 more

Registry-linked trialAbstract read
In one paragraph

Article in Current therapeutic research, clinical and experimental, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01415921 (Augmentation of Parasympathetic Signaling With Pyridostigmine in Heart Failure), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01415921 phase2completednot on this map

Augmentation of Parasympathetic Signaling With Pyridostigmine in Heart Failure

TypeinterventionalSponsorNYU Langone HealthRan2011 to 2015Enrolled33ConditionsHeart FailureArmsPyridostigmine Bromide
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Randal GoldbergDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.
Lucy Norcliffe-KaufmannDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.
Horacio KaufmannDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.
Ikoa Jeschke-LopezDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.
Yu GuoDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.
Judy ZhongDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.
Kenneth I BergerDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.
Roberta M GoldringDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.
David S GoldsteinAutonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
Carey PopeOklahoma State University College of Veterinary Medicine, Stillwater, Oklahoma.
Lara MaxwellOklahoma State University College of Veterinary Medicine, Stillwater, Oklahoma.
Manushree BharadwajOklahoma State University College of Veterinary Medicine, Stillwater, Oklahoma.
Alex ReyentovichDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.
Stuart D KatzDepartments of Medicine, Neurology and Population Health, New York University Grossman School of Medicine, New York, New York.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Pyridostigmine bromide is a short-acting carbamate acetylcholinesterase inhibitor that has been shown to acutely augment parasympathetic signaling in cardiovascular disease populations. Objective: This study was undertaken to characterize pharmacodynamics, safety, and tolerability of pyridostigmine during repeated dosing in patients with heart failure. Methods: A prospective ascending-dose, forced titration, double-blind Phase II randomized clinical trial was conducted to compare the effects of pyridostigmine bromide (15, 30, and 60 mg TID over 8 weeks) versus matching placebo on red blood cell (RBC) acetylcholinesterase activity, cholinergic side effects, and physiologic measures of parasympathetic heart rate modulation and sympathovagal balance in ambulatory patients with chronic systolic heart failure. Results: Fifty subjects were screened, and 33 eligible subjects were randomly assigned (mean age, 55 years; mean left ventricular ejection fraction, 23%). Pyridostigmine bromide significantly decreased RBC acetylcholinesterase activity ( Conclusions: Pyridostigmine bromide administered over 8 weeks was associated with a significant reduction of RBC acetylcholinesterase activity and relatively mild symptoms of cholinergic excess, but changes in parasympathetic signaling in the sinoatrial node previously reported after acute administration were not observed. Further investigations are needed to delineate pharmacodynamic and pathobiological factors contributing to these findings. ClinicalTrials.gov identifier: NCT01415921.

Indexed as

Autonomic nervous systemCholinesterase inhibitionHeart failureHuman studiesPharmacodynamicsPyridostigmineToxicology

Identifiers

PMID41357360
PMCPMC12677105

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.