Dronedarone An antiarrhythmic agent for the management of atrial fibrillation and atrial flutter

作者：Coleman Craig I^*; White C Michael; Baker William L

来源：Formulary, 2009, 44(2): 40-46.

Atrial fibrillation (AF) is a major cause of morbidity and mortality and affects approximately 2.5 million people in the United States. Patients suffering from AF have an increased risk of cardiovascular events and death and have a decreased heath-related quality-of-life. Dronedarone, an investigational antiarrhythmic agent being studied for the management of AF and atrial flutter, has a pharmacologic mechanism of action that is similar to that of amiodarone, but dronedarone lacks an iodine moiety, which may result in less thyroid and pulmonary toxicity. During clinical trials, dronedarone has been demonstrated to decrease AF recurrence by approximately 25% and to reduce the incidence of the combined end point of hospitalization for cardiac causes and all-cause mortality. However, the results of an additional trial suggest that dronedarone should not be used in patients with severe (class III or IV) heart failure, as these patients demonstrated an increased mortality risk with dronedarone treatment. Worsening renal function has also been associated with dronedarone, but the clinical relevance of this is a matter of some debate. Dronedarone is currently pending FDA approval; the agent was granted priority review in August 2008. (Formulary. 2009;44:40-46.)

• 出版日期2009-2