Drug safety evaluation of dronedarone in atrial fibrillation

Gaetano M. De Ferrari, Veronica Dusi

Research output: Contribution to journalArticle

Abstract

Introduction: Dronedarone was developed with the intent of replicating the antiarrhythmic effects of amiodarone, while minimizing its side effects. Areas covered: Side effects reported in eight randomized clinical trials are discussed, comparing dronedarone and placebo (DAFNE, EURIDIS, ADONIS, ERATO, ANDROMEDA, ATHENA, PALLAS, total number of patients treated with dronedarone 5347), or dronedarone and amiodarone (DIONYSOS, total number of patients treated with dronedarone 249). Expert opinion: The results of the first trials, including ATHENA, set high expectations by suggesting that dronedarone may decrease the risk of hospitalization (and even cardiovascular mortality) among patients with paroxysmal and persistent atrial fibrillation (AF), and that it could be regarded as an easy-to-use drug that could be prescribed by general practitioners; unfortunately, dronedarone has not met these expectations. Dronedarone may increase mortality and heart failure hospitalization in patients with advanced NYHA class and in patients with permanent AF, preventing its use in these settings. In addition to gastrointestinal side effects that may lead to discontinuation in 5 10% of patients, dronedarone may induce very rare but severe liver and lung toxicity. Despite these limitations and its relatively limited antiarrhythmic potency, dronedarone may still be a useful drug for well-selected patients.

Original languageEnglish
Pages (from-to)1023-1045
Number of pages23
JournalExpert Opinion on Drug Safety
Volume11
Issue number6
DOIs
Publication statusPublished - Nov 2012

Keywords

  • Amiodarone
  • Antiarrhythmic therapy
  • Atrial fibrillation
  • Clinical trials
  • Dronedarone
  • Heart failure
  • Safety
  • SR33589

ASJC Scopus subject areas

  • Pharmacology (medical)

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