Dronedarone: Una reale innovazione o solo una valida seconda scelta? Come districarsi tra linee guida, agenzie regolatorie e pratica clinica quotidiana

Translated title of the contribution: Dronedarone: A real innovation or just a valid second choice? How to disentangle between the guidelines, regulating agency and daily clinical practice

Alessandro Capucci, Federico Guerra, Cesare Antenucci, Roberto Antonicelli, Paolo Bocconcelli, Giuseppe Boriani, Paolo Busacca, Nino Ciampani, Stefano Della Casa, Domenico Gabrielli, Marcello Galvani, Massimo Margheri, Francesco Melandri, Maria Grazia Modena, Gian Piero Perna, Pierluigi Pieri, Giancarlo Piovaccari, Andrea Pozzolini, Claudio Rapezzi, Giovanni Quinto Villani

Research output: Contribution to journalArticle

Abstract

Dronedarone is the antiarrhythmic drug with the most complete and wide literature preceding its marketing. Most of these studies showed a good efficacy along with an excellent risk profile, especially in low- and medium- risk patients. Recently, updates of European, American and even Italian guidelines gave dronedarone its own spot into the antiarrhythmic armamentarium, recommending its use both for rhythm control and rate control in non-permanent atrial fibrillation. In Italy, however, dronedarone prescription is still possible only when amiodarone is not tolerated, making dronedarone a mere second choice of its older "relative". Moreover, patients taking dronedarone must undergo a strict alanine aminotransferase and bilirubin follow-up, which usefulness in predicting drug-induced liver damage (probably idiosyncratic in nature and therefore unpredictable) is far from demonstrated. The aim of this review is to sum up actual evidences on dronedarone, describe how these evidences had been differently transposed by panel of experts and drug agencies into guidelines and recommendations, and define the current difficulties encountered by the cardiologist in the correct use of this new antiarrhythmic agent in clinical practice.

Translated title of the contributionDronedarone: A real innovation or just a valid second choice? How to disentangle between the guidelines, regulating agency and daily clinical practice
Original languageItalian
Pages (from-to)326-333
Number of pages8
JournalGiornale Italiano di Cardiologia
Volume13
Issue number5
DOIs
Publication statusPublished - May 2012

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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