Onoact (landiolol) / Ono Pharma - LARVOL DELTA

CARDIOVASCULAR EFFECTS OF LANDIOLOL IN INTENSIVE CARE PATIENTS: A RETROSPECTIVE SAFETY ANALYSIS (CHEST 2025) - "In our experience, landiolol appears to be a safe option for treating supraventricular tachyarrhythmia in ICU patients. Careful dose titration to target HR, as recommended by atrial fibrillation guidelines, can be achieved with relatively low doses of landiolol, with minimal impact on blood pressure and stable vasopressor requirements over time. CLINICAL IMPLICATIONS: Landiolol appears to be a safe option for treating supraventricular tachyarrhythmia in ICU patients."

Retrospective data • Atrial Fibrillation • Cardiovascular • Critical care • Septic Shock • Ventricular Tachycardia

COMPARATIVE EFFECTIVENESS OF BETA BLOCKERS ON MORTALITY AND CLINICAL OUTCOMES IN ADULTS WITH SEPTIC SHOCK: A COMPREHENSIVE SYSTEMATIC REVIEW AND BAYESIAN NETWORK META-ANALYSIS (CHEST 2025) - "Esmolol appears to be the most effective beta blocker for reducing mortality and improving clinical outcomes in septic shock. It showed significant reductions in 28-day mortality, ICU mortality, heart rate, and serum lactate levels, as well as a shorter ICU stay. In comparison, landiolol demonstrated less effectiveness."

Clinical data • HEOR • Retrospective data • Review • Metabolic Disorders • Septic Shock

Differential Mortality Benefit of Beta-blockers in Septic Shock: A Subgroup Meta-analysis. (PubMed, Indian J Crit Care Med) - "Esmolol appears beneficial, while Ivabradine and Landiolol show no clear mortality advantage. Differential Mortality Benefit of Beta-blockers in Septic Shock: A Subgroup Meta-analysis. Indian J Crit Care Med 2025;29(8):704-707."

Journal • Retrospective data • Cardiovascular • Septic Shock

Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation in the Acute Care Setting: A Narrative Review. (PubMed, J Clin Med) - "Considering on the one hand its serious adverse effects and complex drug interactions, and on the other hand discrepancies among recent international guidelines, the indications of amiodarone to both prevent and treat POAF should be reserved to patients at high risk of POAF only, or patients with hemodynamic instability and/or severely reduced left ventricular ejection fraction. Given their efficient and safe profile, ultra-short-acting intravenous beta-blockers like esmolol or landiolol could be preferentially used in acute care patients. Besides waiting for the results of ongoing RCTs in cardiac and noncardiac surgery, the use of oral anticoagulation in patients with POAF should take into account the individualized thromboembolic/hemorrhagic risk ratio."

Journal • Review • Atrial Fibrillation • Cardiovascular • Hematological Disorders

Hemodynamic Changes Following Landiolol Initiation in Patients With Critical Illness Who Developed Tachycardia During Dobutamine Infusion: A Retrospective Observational Study. (PubMed, Cureus) - "Conclusions Landiolol effectively reduced HR without reducing MAP in critically ill patients with dobutamine-induced tachycardia. Furthermore, landiolol may promote rhythm control and improve metabolic parameters such as lactate levels."

Journal • Observational data • Retrospective data • Atrial Fibrillation • Cardiovascular • Critical care • Hypotension

Ahnak and Nckap1l as potential diagnostic biomarkers and therapeutic targets in Landiolol-mediated sepsis treatment. (PubMed, Comput Biol Chem) - "Ahnak and Nckap1l are potential diagnostic biomarkers and targets for therapeutic intervention in landiolol-induced sepsis following administration of Landiolol. Nckap1l can be used for endotype analysis of sepsis."

Biomarker • Journal • Infectious Disease • Septic Shock

Anesthesia management for a case of acute myocardial infarction with moderate to severe aortic valve stenosis undergoing total gastrectomy (ASA 2025) - "During the operation, alfentanil was pumped to control stress reaction, and landiolol was used to control ventricular rate. After the operation, epidural analgesia was used, and the patient recovered smoothly and was discharged from the hospital."

Clinical • Anesthesia • Atrial Fibrillation • Cardiovascular • Coronary Artery Disease • Heart Failure • Myocardial Infarction

A Multicentre Observational Study on Landiolol Use, Efficacy, and Safety in European Patients with Supraventricular Arrhythmia (Landi-UP). (PubMed, Eur Heart J Acute Cardiovasc Care) - "In European clinical practice, landiolol dosing adhered to product information recommendations. Landiolol was effective in controlling HR with minimal impact on BP. The treatment was well tolerated, and no new safety signals were identified. These findings support the efficacy and safety of landiolol across diverse clinical settings in Europe."

Journal • Observational data • Atrial Fibrillation • Cardiovascular

Targeted Heart Rate Control with Landiolol in Hemodynamically Unstable, Non-Surgical Intensive Care Unit Patients: A Comparative Study. (PubMed, Medicina (Kaunas)) - " Landiolol achieved more effective HR control than standard therapy without adversely affecting BP stability. These findings suggest that landiolol may be a feasible and effective option for HR control in ICU CIP."

Clinical • Journal • Atrial Fibrillation • Cardiovascular • Critical care • Septic Shock

LANTA-P: LANdiolol to Avoid TAchycardia in Patients at Risk for Cardiovascular Events Undergoing Major Non-cardiac Surgery (clinicaltrials.gov) - P4 | N=114 | Not yet recruiting | Sponsor: Insel Gruppe AG, University Hospital Bern

New P4 trial • Cardiovascular

From Evidence to Bedside: The Role of Short-Acting β-Blockers in Sepsis Care. (PubMed, Cardiol Rev) - "This review synthesizes current data on the safety and efficacy of short-acting, cardioselective β-blockers (BBs), particularly esmolol and landiolol, in septic shock. Future multicenter trials are needed to validate its efficacy and establish clinical guidelines. Clinicians should remain cautiously optimistic when considering BBs for select patients with refractory tachycardia postresuscitation, ideally within structured protocols or ongoing research efforts."

Journal • Cardiovascular • Infectious Disease • Septic Shock

An exploratory study of landiolol plus amiodarone versus amiodarone monotherapy in paediatric junctional ectopic tachycardia after surgery. (PubMed, Cardiol Young) - "In this retrospective analysis, combined landiolol and amiodarone therapy demonstrated a shorter time to heart rate control compared to amiodarone alone, especially when landiolol was initiated first. These findings require confirmation in prospective studies."

Journal • Monotherapy • Cardiovascular • Hypotension • Pediatrics

Utility of perioperative beta blocker therapy in patients undergoing cardiac surgery (ESC-WCC 2025) - "Subgroup analysis shows this association was primarily with use of IV Landiolol and with a non-statistically significant trend toward lower risk of AFib in patients initiated or maintained on oral beta blockers (OR 0.29, 95% CI 0.20-0.41; p<0.01; OR 0.62, 95% CI 0.33-1.16; P=0.06)...Discussion This meta-analysis demonstrates that in patients who are undergoing cardiac surgery, preoperative initiation of beta-blockers, particularly IV Landilol, or continuation of chronic beta-blockers is associated with a lower risk of adverse cardiovascular outcomes, particularly post-operative AFib and SVT. The use of beta-blockers may also be associated with a mortality benefit, however additional high-quality studies with extended follow-up time and monitoring are needed to fully elucidate this association."

Clinical • Surgery • Atrial Fibrillation • Cardiovascular • Ventricular Tachycardia

LANdiolol MIcrocirculatory Effects During Septic chOc (MILANOS) (clinicaltrials.gov) - P3 | N=44 | Recruiting | Sponsor: Assistance Publique - Hôpitaux de Paris | Trial completion date: Jan 2024 ➔ Jul 2026 | Trial primary completion date: Jan 2024 ➔ Jul 2026

Trial completion date • Trial primary completion date • Septic Shock

HyperBetashock: Comparison of Landiolol Versus Standard of Care for Prevention of Mortality in Patients Hospitalized for a Septic Shock With Hypercontractility (clinicaltrials.gov) - P3 | N=360 | Recruiting | Sponsor: Centre Hospitalier Universitaire, Amiens | Trial completion date: Mar 2026 ➔ Sep 2027 | Trial primary completion date: Jun 2025 ➔ Jun 2027

Trial completion date • Trial primary completion date • Cardiovascular • Septic Shock

Efficacy and Safety of Landiolol in the Treatment of Tachycardia in Patients With Sepsis and Septic Shock: A Systematic Review and Meta-Analysis. (PubMed, Cureus) - "Landiolol, a highly selective ultrashort-acting β1-blocker with distinct pharmacokinetic properties from esmolol, reduces HR in patients with sepsis-related TA without significantly affecting 28-day mortality. However, results should be interpreted cautiously as only three small trials underpin these results. To our knowledge, this is the first MA to focus exclusively on landiolol in this setting, offering drug-specific insights for critical care management."

Journal • Retrospective data • Review • Atrial Fibrillation • Cardiovascular • Critical care • Hypotension • Infectious Disease • Septic Shock

The Role of Landiolol in Coronary Artery Disease: Insights into Acute Coronary Syndromes, Stable Coronary Artery Disease and Computed Tomography Coronary Angiography. (PubMed, J Clin Med) - "It has been increasingly recognized for its importance in both acute (primarily studied in STEMI and, to a lesser extent, NSTEMI pPCI) and chronic (mainly studied in elective PCI) CAD settings. Given the limited literature focusing specifically on landiolol, the aim of this narrative review is to examine its pharmacological properties and evaluate its current and future role in enhancing both diagnostic imaging quality and therapeutic outcomes in patients with CAD."

Journal • Review • Acute Coronary Syndrome • Cardiovascular • Coronary Artery Disease • Myocardial Infarction

The lack of evidence-based management in electrical storm: a scoping review. (PubMed, BMC Cardiovasc Disord) - "Amiodarone, quinidine, landiolol, isoproterenol, and mexiletine were the most studied medications. Existing evidence to guide the management of ES is predominantly based on small observational studies. High quality data to inform the management of ES is needed."

Journal • Anesthesia • Cardiovascular • Ventricular Tachycardia

Landiolol (Rapiblyk), A Newly Approved, Ultra-Short Acting Intravenous β1-Adrenoreceptor Blocker for the Treatment of Supraventricular Arrhythmias. (PubMed, Cardiol Rev) - "Other intravenous β-blockers approved for the same indication include esmolol (Brevibloc) and generics, and propranolol generics...Other rate-reducing treatments include intravenous nondihydropyridine calcium channel blockers such as diltiazem and verapamil. Etripamil is also being evaluated as a parenteral intranasal formulation for arrhythmia management. The clinical effectiveness, pharmacokinetic properties, and side effect profile of landiolol are reviewed in this article. At this juncture, the effectiveness of the drug in reducing the heart rate in patients with supraventricular arrhythmias, including atrial fibrillation and flutter, has been demonstrated to be as effective as generic β-blockers and calcium channel blockers."

Journal • Atrial Fibrillation • Cardiovascular • Ventricular Tachycardia

Landiolol bolus application for tachycardic dysrhythmia in the prehospital EMS setting - An observational study of a novel concept. (PubMed, Scand J Trauma Resusc Emerg Med) - "Push-dose Landiolol could be a conceivable future therapeutic option for tachydysrhythmia in the EMS setting. In particular, a high incidence of rate or rhythm control can be achieved. Utilization should be allocated to non-compensatory tachycardia only. Drug response and control groups with other drugs should be further investigated."

Journal • Observational data • Allergy • Atrial Fibrillation • Cardiovascular • Pain • Pulmonary Disease

An external validation of polygenic risk scores in the general population using measured GFR – the Renal Iohexol Clearance Survey (RENIS) (ERA 2025) - "PGS developed from eGFRcrea show reduced performance in external validation when mGFR is used as the phenotype. The performance further declines with eGFRcys as the phenotype. The impact of SNVs on bias is more pronounced for eGFRcys than for eGFRcrea."

Clinical • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Metabolic Disorders • Nephrology • Renal Disease • CST3

Efficacy of Landiolol for Treatment of Sepsis-Related Tachyarrhythmia: Lost in Translation. (PubMed, Am J Cardiovasc Drugs) - No abstract available

Journal • Cardiovascular • Infectious Disease • Septic Shock

Successful use of terlipressin to treat refractory shock after adrenal vein ligation in pheochromocytoma surgery (Euroanaesthesia 2025) - "Chronic elevation of catecholamines may also suppress vasopressin synthesis.Case Report: A 36-year-old female patient with a medical history of a 14x10 cm right adrenal paraganglioma (pheochromocytoma) metastatic to liver and secreting metanephrine (>100x normal levels) and normetanephrine (>40x normal levels) underwent open surgery after 2 weeks of pharmacological preparation with prazosin. Intraoperative tachycardia events were treated with landiolol and hypertensive events (systolic blood pressure >180 mmHg) with a continuous infusion of urapidil...Terlipressin is used with multiple-dose regimens in refractory septic shock [2] with a usual dose of 1 mg each 4 to 6 hours but this high dose can be associated with side effects and complications, such as mesenteric and digital ischemia. A low dose of terlipressin (bolus 0.5 mg or low continuous dose 1-2 mcg/kg/hr) can be sufficient to reverse hypotension and minimize side effects."

Surgery • Cardiovascular • Endocrine Cancer • Hypotension • Oncology • Septic Shock • Solid Tumor • ADRB2

Comparison of Landiolol and Esmolol on Haemodynamic Responses During Weaning of Intensive Care Unit Patients with Reduced Ejection Fraction after Vascular Surgery. (PubMed, Card Fail Rev) - "Landiolol produced a more rapid and potent reduction in heart rate than esmolol. A significant reduction in MAP was only seen in the esmolol group."

Journal • Cardiovascular • Congestive Heart Failure • Critical care • Heart Failure

HyperBetashock: Comparison of Landiolol Versus Standard of Care for Prevention of Mortality in Patients Hospitalized for a Septic Shock With Hypercontractility (clinicaltrials.gov) - P3 | N=360 | Recruiting | Sponsor: Centre Hospitalier Universitaire, Amiens | Phase classification: P=N/A ➔ P3 | Trial completion date: Mar 2024 ➔ Mar 2026 | Trial primary completion date: Feb 2024 ➔ Jun 2025

Phase classification • Trial completion date • Trial primary completion date • Cardiovascular • Septic Shock