Atenolol
| Evidence Level: L4 | Predicted Indications: 9 |
Table of Contents
Atenolol: From Beta-Blocker Therapy to Posteroinferior Myocardial Infarction
One-Sentence Summary
Atenolol is an oral beta-1 blocker marketed in the United States under one brand-name NDA and multiple generic ANDAs. The TxGNN model predicts it may be effective for posteroinferior myocardial infarction, but only 0 clinical trials and 1 publication (a 1985 crossover study) are linked to this indication. The current label may already cover myocardial infarction, so this may not be a true repurposing case.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not listed in the available regulatory data (approved indication text is blank for all retrieved licenses) |
| Predicted New Indication | Posteroinferior myocardial infarction |
| TxGNN Prediction Score | 99.87% |
| Evidence Level | L4 |
| US Market Status | ✓ Marketed |
| Number of NDAs | 20 (the 5 licenses shown are 1 NDA and 4 ANDAs) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on known information, atenolol is a beta-1 selective adrenergic blocker. Beta-1 blockade lowers heart rate, contractility and myocardial oxygen demand, and beta-blockers are established in the myocardial infarction (MI) setting. This makes an anti-ischemic effect after a posteroinferior MI mechanistically plausible.
The original indication field is empty, so the relationship between the original and new indication cannot be assessed. The current label should be checked first, because MI may already be covered.
The only supporting literature is a 1985 randomized crossover study of anti-ischemic activity. Its focus appears to be exercise-induced ischemia rather than MI outcomes, so it is indirect evidence. The TxGNN score is very high, but the same score was assigned to posterolateral MI, so it mainly reflects proximity in the knowledge graph.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 3901170 | 1985 | RCT (single-blind, crossover; inferred from title) | La Revue de medecine interne | Compared the anti-ischemic activity of atenolol 200 mg and diltiazem 240 mg in 23 patients 4 weeks after a limited postero-inferior or anterior MI. Each patient had a placebo exercise test and one test per randomized drug. The abstract is truncated, so results are not available. |
US Market Information
Five of 20 authorizations are shown. Indication text is not provided in the source data.
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| NDA018240 | TENORMIN | Tablet | Not provided in source data |
| ANDA077443 | atenolol | Tablet | Not provided in source data |
| ANDA074056 | Atenolol | Tablet | Not provided in source data |
| ANDA078512 | Atenolol | Tablet | Not provided in source data |
| ANDA076900 | Atenolol | Tablet | Not provided in source data |
Safety Considerations
Please refer to the package insert for safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The mechanism is plausible, but there are no registered trials for this indication. The only publication is a small 1985 study that appears to measure exercise-induced ischemia rather than MI outcomes. The current label is also unverified, so this may not be a genuine repurposing case. The seven other predictions (posterolateral MI, septal MI, malignant hypertension subtypes, pulmonary hypertension subtypes, Braddock syndrome, chronic pulmonary heart disease) also have no direct evidence. The pulmonary ones raise a beta-blockade safety concern.
To proceed, the following is needed:
- Confirm the current US label indications, especially whether MI is already covered
- Retrieve the full text of PMID 3901170 and confirm its endpoints and results
- Search for MI-specific evidence for atenolol (randomized trials, meta-analyses, guidelines)
- Obtain the package insert warnings and contraindications
- Obtain detailed mechanism of action data (MOA) from DrugBank
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.