Critical appraisal and clinical utility of atosiban in the management of preterm labor

Abstract

Preterm birth is the major cause of perinatal morbidity and mortality in the developed world, and spontaneous preterm labor is the commonest cause of preterm birth. Interventions to treat women in spontaneous preterm labor have not reduced the incidence of preterm births but this may be due to increased risk factors, inclusion of births at the limits of viability, and an increase in the use of elective preterm birth. The role of antibiotics remains unproven. In the largest of the randomized controlled trials, evaluating the use of antibiotics for the prevention of preterm births in women in spontaneous preterm labor, antibiotics against anaerobes and bacterial vaginosis-related organisms were not included, and no objective evidence of abnormal genital tract flora was obtained. Atosiban and nifedipine are the main tocolytic agents used to treat women in spontaneous preterm labor, but atosiban is the tocolytic agent with the fewest maternal – fetal side effects. A well conducted randomized controlled trial comparing atosiban with nifedipine for their effectiveness and safety is needed.

Intranasal Oxytocin Attenuates Reactive and Ongoing, Chronic Pain in a Model of Mild Traumatic Brain Injury

“…Atosiban is a nonapeptide, desamino‐oxytocin analog, and a competitive vasopressin/OT receptor antagonist . To investigate if a potential pain attenuating effect of OT could be blocked by a receptor antagonist, 12 rats were randomized to receive either intranasal OT combined with an intraperitoneal administered vehicle or intranasal OT combined with an intraperitoneal administered atosiban (0.3 mg, Sigma, St. Louis, USA, diluted in 2 mL saline).…”

“…OT Receptor Antagonist Atosiban.-Atosiban is a nonapeptide, desamino-oxytocin analog, and a competitive vasopressin/OT receptor antagonist. 39 To investigate if a potential pain attenuating effect of OT could be blocked by a receptor antagonist, 12 rats were randomized to receive either intranasal OT combined with an intraperitoneal administered vehicle or intranasal OT combined with an intraperitoneal administered atosiban (0.3 mg, Sigma, St. Louis, USA, diluted in 2 mL saline). Atosiban was given immediately prior to intranasal OT administration and, apart from the intraperitoneal injections, the protocol did not differ from the previously described procedure of intranasal delivery of OT.…”

Vasopressin V1a and V1b Receptors: From Molecules to Physiological Systems

“…When the effectiveness and safety of atosiban in tocolytic therapy was compared with conventional ␤-adrenergic receptor agonists in a doubleblind, comparative-controlled study, atosiban was found to be as effective as the ␤-adrenergic receptor agonists and had fewer maternal side effects, especially in terms of adverse cardiovascular events (191)(192)(193)306). A randomized controlled clinical study is needed to compare the effectiveness of atosiban versus a calcium channel blocker (438). Both atosiban and SR49059 have a high affinity for the V1a receptor (K i ϭ 4.7 and 7.2 nM, respectively), and a moderate affinity for the OT receptor (K i ϭ 397 and 340 nM, respectively) (11).…”

The Effects of Oxytocin and Oxytocin Receptor Antagonist Atosiban on the Carbonic Anhydrase and Acetylcholinesterase Enzymes from Lung Tissues of Rats

“…Along with its known effects, OT has many other effects which have been revealed recently and a part of which is still under discussion. Some of the physiological effects of OT can be described as its effects on reproduction, diabetes metabolism, thymus physiology and immune system, sexual and nutritional behaviors, cardiovascular system, medulla spinalis and sensation of pain [2].…”