Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(6), 589–597. https://doi.org/10.1002/clc.24011 Dr. Jagmeet P. Singh et al.
Points
- The research paper compared the safety and efficacy of two commonly used antiarrhythmic drugs, dronedarone, and sotalol, in adult patients with non-permanent atrial fibrillation (AF).
- A systematic literature review was conducted, including 37 studies comprising randomized controlled trials (23), observational studies (13), and a nonrandomized trial (1).
- Dronedarone had a significantly lower risk of all-cause death than sotalol, with a hazard ratio of 0.38 (95% credible interval: 0.19, 0.74).
- However, no significant differences were observed between the two drugs regarding AF recurrence and cardiovascular death in the overall analysis and sensitivity analyses.
- These findings provide valuable comparative data for clinicians in making informed treatment decisions for patients with nonpermanent AF, highlighting the lower risk of all-cause death associated with dronedarone compared to sotalol. Further research and randomized controlled trials are needed to validate these results.
Summary
This research paper aimed to compare the safety and efficacy of two commonly prescribed Vaughan-Williams (VW) class III antiarrhythmic drugs (AADs), dronedarone and sotalol, in adult patients with non-permanent atrial fibrillation (AF). The study conducted a systematic literature review and included 37 unique studies comprising 23 randomized controlled trials (RCTs), 13 observational studies, and one nonrandomized trial. The researchers utilized Bayesian random-effects network meta-analysis (NMA) to assess the comparative safety and efficacy of the two drugs.
Among the 3581 records identified through the database searches, the NMA analysis included 37 studies. The results revealed that dronedarone was associated with a statistically significantly lower risk of all-cause death than sotalol, as indicated by a hazard ratio (HR) of 0.38 (95% credible interval, CrI: 0.19, 0.74). In the sensitivity analysis, which included only RCTs, the association remained consistent, with a numerically similar HR of 0.46 (95% CrI: 0.21, 1.02). However, no significant differences were observed between dronedarone and sotalol regarding AF recurrence and cardiovascular death in the overall analysis of all studies and the sensitivity analyses.
These findings provide valuable comparative data on the safety and efficacy of dronedarone and sotalol in maintaining sinus rhythm in adult patients with nonpermanent AF. The results suggest that dronedarone, compared to sotalol, is associated with a lower risk of all-cause death. However, the two drugs had no discernible disparities in AF recurrence and cardiovascular death. These findings have implications for clinical practice, assisting healthcare professionals in making informed treatment decisions for patients with atrial fibrillation. Further research and randomized controlled trials are warranted to validate and expand upon these findings.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24011
References Singh, J. P., Blomström‐Lundqvist, C., Turakhia, M. P., Camm, A. J., Fazeli, M. S., Kreidieh, B., Crotty, C., & Kowey, P. R. (2023). Dronedarone versus sotalol in patients with atrial fibrillation: A systematic literature review and network meta‐analysis. Clinical Cardiology, 46(6), 589–597. https://doi.org/10.1002/clc.24011
