Which patient is most likely to benefit from dronedarone? Analysis from the Magdeburg Dronedarone Registry (MADRE study)

J Clin Pharmacol. 2013 Aug;53(8):841-5. doi: 10.1002/jcph.103. Epub 2013 May 29.

Abstract

Based on an analysis of the Magdeburg Dronedarone Registry data we sought to determine which patients could benefit from dronedarone therapy regarding rhythm control. The study included 191 patients (85 women) aged 63 ± 10 years with a history of paroxysmal or persistent AF and a follow-up of 14 ± 5 months. The total AF recurrence rate was 67% and lone AF was significantly more often associated with AF recurrences than non-lone AF (84% vs. 62%, P = .01). Arterial hypertension, treated coronary artery disease, and diabetes mellitus were not significantly related to AF recurrences (64%, 67%, 58% resp. P = .3). Response rate to dronedarone in patients with slightly increased left atrial size was significantly greater than in patients with normal or markedly increased left atrial size (47%, 16%, 27% resp., P = .001). The rate of adverse effects was 32% in the study sample, and was significantly lower in patients with lone AF as compared to those with non-lone AF (11% vs. 37%, P = .002). The body mass index was a predictor neither of response rate nor adverse effects. The results suggest that dronedarone is more effective in patients with non-lone AF and slightly increased left atrial size.

Keywords: antiarrhythmic drugs; atrial fibrillation; dronedarone.

MeSH terms

  • Aged
  • Amiodarone / analogs & derivatives*
  • Amiodarone / therapeutic use
  • Anti-Arrhythmia Agents / therapeutic use*
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / pathology
  • Dronedarone
  • Female
  • Heart Atria / pathology
  • Humans
  • Male
  • Middle Aged
  • Organ Size
  • Recurrence
  • Registries

Substances

  • Anti-Arrhythmia Agents
  • Dronedarone
  • Amiodarone