Dronedarone:当前证据和未来的问题。

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谢弗杰,Kjesbo NK,格里森页

Dronedarone:当前证据和未来的问题。

Cardiovasc。2010年春天,28 (1):38-47。doi: 10.1111 / j.1755-5922.2009.00112.x。

PubMed ID

20074258 (在PubMed

]

文摘

心房颤动(房颤)是最常见的持续性心律失常,影响超过220万美国人。ACC / AHA / ESC房颤患者的管理指南推荐胺碘酮维持窦性节律。Dronedarone导数的胺碘酮治疗房颤表示。与重点概述Dronedarone Dronedarone的III期试验和讨论未解决的问题。通过PubMed数据库进行文献搜索使用关键字“dronedarone。”搜索was limited to human trials in english. The FDA website was searched for briefing documents and subcommittee meetings on dronedarone. Clinicaltrials.gov was searched with the keyword dronedarone for upcoming or unpublished clinical trials. Five phase III trials are available for dronedarone: ANDROMEDA, EURIDIS/ADONIS, ATHENA, ERATO, and DIONYSIS. EURIDIS/ADONIS and ATHENA demonstrated a reduction AF recurrence with dronedarone compared to placebo. The ANDROMEDA trial recruited patients with recent hospitalization for heart failure and was terminated due to an excess of deaths in the dronedarone group. The DIONYSIS trial was a comparative effectiveness trial that demonstrated less efficacy for dronedarone but improved tolerability compared to amiodarone. Dronedarone represents an option in the management of AF in select patients. Dronedarone is not appropriate in patients with recently decompensated heart failure or those treated with strong CYP3A4 inhibitors or medications prolonging the QT interval. Dronedarone appears to have improved tolerability at the expense of decreased efficacy when compared to amiodarone. Questions remain on the long-term safety, use in patients with heart failure, retreatment after dronedarone or amiodarone failure, and comparative efficacy with a rate control strategy.

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药物酶

药物	酶	类	生物	药理作用	行动
Dronedarone	细胞色素P450 2 d6	蛋白质	人类	未知的	底物 抑制剂	细节
Dronedarone	细胞色素P450 3 a4	蛋白质	人类	未知的	底物 抑制剂	细节

药物转运蛋白

药物	转运体	类	生物	药理作用	行动
Dronedarone	22 - 1	蛋白质	人类	没有	抑制剂	细节