Taking Cordarone for short time not an option -study

Taking the Wyeth heart drug Cordarone for shorter periods of time did little to ease side effects and left patients with a higher risk of premature death than those taking it for long periods, Dutch researchers said on Tuesday.

Long-term use of the drug known generically as amiodarone is common for people with a type of irregular heart beat known as atrial fibrillation. But because it can cause allergies, liver, lung and other health problems, the researchers said they wanted to see if cutting time on the drug could help.

This was not the case, Isabelle Van Gelder of the University of Groningen in the Netherlands and colleagues reported in the Journal of the American Medical Association.

“This study shows that episodic amiodarone treatment - in contrast to our expectations - has no clinical advantage over continuous treatment because it did not lower morbidity in patients with persistent atrial fibrillation over 2 years of follow-up.”

Amiodarone is used to control atrial fibrillation, a common but serious condition that causes the heart’s upper chambers to flutter. It is important to treat the condition to prevent stroke. Many heart drugs can help, including those designed to slow the rapid heart rate associated with atrial fibrillation and blood thinners or anticoagulants that make a clot less likely to form.

In August U.S. health officials warned the public about the risk of a rare type of muscle injury seen when the cholesterol drug simvastatin is combined with amiodarone.

The Dutch trial included 209 men and women with irregular heartbeats assigned to receive either continuous or short-term treatment of two months. The researchers put those in the short-term group back on medication for a 2-month burst if their irregular heartbeats returned.

When the researchers followed up at two years, they found about half the people on reduced treatment had normal heartbeats compared with about 64 percent of people who had been on the medicine for the entire two years.

Serious problems from the drug or an underlying condition that required hospitalisation or medical intervention were slightly higher in the short-term group, Van Gelder said in a telephone interview.

And the number of deaths from any cause was about 53 percent in the short-term group, compared with 34 percent among the other volunteers, indicating that reducing the drug is not an option for doctors, the researchers added.

“Considering the above, episodic amiodarone treatment cannot be advocated for most patients with persistent atrial fibrillation,” they wrote.

By Michael Kahn
LONDON (Reuters)