Dronedarone: a novel antiarrhythmic agent for the treatment of atrial fibrillation.
OBJECTIVE
To describe the electrophysiological profile and the clinical portfolio of dronedarone, a new multichannel-blocking antiarrhythmic drug developed for the treatment of atrial fibrillation.


RESULTS
Dronedarone is a derivative of amiodarone that is free of iodine and less lipophilic. The drug has - as its predecessor - multichannel-blocking efficacy and in addition vasodilating effects. It reduces the incidence of ventricular fibrillation in several experimental models. Dronedarone has undergone thorough clinical evaluation in various patient populations. In two large trials, the drug was shown to postpone the recurrence of atrial fibrillation after cardioversion relative to placebo. In a trial in unstable heart failure patients, there was excess mortality in the dronedarone arm. This trial was stopped prematurely and prompted the conduct of a large outcome study. The ATHENA trial demonstrated a significant reduction in cardiovascular hospitalizations and death in atrial fibrillation patients randomly assigned to receive dronedarone or placebo. This large trial in more than 4600 patients revealed no signs of excess mortality or morbidity in patients receiving dronedarone.


CONCLUSIONS
On the basis of the results of five international, multicenter, randomized clinical trials involving nearly 6300 patients, dronedarone was approved by the FDA for treatment of nonpermanent atrial fibrillation to reduce the risk of cardiovascular hospitalization.
Duray
Gabor Z
GZ
J. W. Goethe University, Frankfurt, Germany.
Ehrlich
Joachim R
JR
Hohnloser
Stefan H
SH
D018674:Adrenergic Antagonists / Q000494:pharmacology; D000638:Amiodarone / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D000077764:Dronedarone; D006801:Humans; D007473:Ion Channels / Q000037:antagonists & inhibitors; D016032:Randomized Controlled Trials as Topic; D014665:Vasodilator Agents / Q000494:pharmacology
D018674:Adrenergic Antagonists; D000889:Anti-Arrhythmia Agents; D007473:Ion Channels; D014665:Vasodilator Agents; D000077764:Dronedarone; D000638:Amiodarone