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A short-term, randomized, double-blind, parallel-group study to evaluate the efficacy and safety of dronedarone versus amiodarone in patients with persistent atrial fibrillation: the DIONYSOS study.
- Source :
-
Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2010 Jun 01; Vol. 21 (6), pp. 597-605. Date of Electronic Publication: 2010 Apr 06. - Publication Year :
- 2010
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Abstract
- Introduction: We compared the efficacy and safety of amiodarone and dronedarone in patients with persistent atrial fibrillation (AF).<br />Methods: Five hundred and four amiodarone-naïve patients were randomized to receive dronedarone 400 mg bid (n = 249) or amiodarone 600 mg qd for 28 days then 200 mg qd (n = 255) for at least 6 months. Primary composite endpoint was recurrence of AF (including unsuccessful electrical cardioversion, no spontaneous conversion and no electrical cardioversion) or premature study discontinuation. Main safety endpoint (MSE) was occurrence of thyroid-, hepatic-, pulmonary-, neurologic-, skin-, eye-, or gastrointestinal-specific events, or premature study drug discontinuation following an adverse event.<br />Results: Median treatment duration was 7 months. The primary composite endpoint was 75.1 and 58.8% with dronedarone and amiodarone, respectively, at 12 months (hazard ratio [HR] 1.59; 95% confidence interval [CI] 1.28-1.98; P < 0.0001), mainly driven by AF recurrence with dronedarone compared with amiodarone (63.5 vs 42.0%). AF recurrence after successful cardioversion was 36.5 and 24.3% with dronedarone and amiodarone, respectively. Premature drug discontinuation tended to be less frequent with dronedarone (10.4 vs 13.3%). MSE was 39.3 and 44.5% with dronedarone and amiodarone, respectively, at 12 months (HR = 0.80; 95% CI 0.60-1.07; P = 0.129), and mainly driven by fewer thyroid, neurologic, skin, and ocular events in the dronedarone group.<br />Conclusion: In this short-term study, dronedarone was less effective than amiodarone in decreasing AF recurrence, but had a better safety profile, specifically with regard to thyroid and neurologic events and a lack of interaction with oral anticoagulants.
- Subjects :
- Aged
Amiodarone adverse effects
Anti-Arrhythmia Agents adverse effects
Double-Blind Method
Dronedarone
Electrocardiography drug effects
Endpoint Determination
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Nervous System Diseases chemically induced
Risk Assessment
Thyroid Diseases chemically induced
Amiodarone analogs & derivatives
Amiodarone therapeutic use
Anti-Arrhythmia Agents therapeutic use
Atrial Fibrillation drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8167
- Volume :
- 21
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 20384650
- Full Text :
- https://doi.org/10.1111/j.1540-8167.2010.01764.x