Humour based Cardiology- Dronidarone :When Inefficiency becomes an advantage ?
Posted Sep 17 2010 8:38am
Dronedarone is a drug which was developed to replace the very effective , (but side effect prone ) antiarrhythmic drug Amiodarone.
After years of study , Dronedarone has been approved for use in some* of our patients with atrial fibrillation
* Who are they ?
That is the only thing , we are unclear about Dronedarone ! ! !
The recent studies on Dronedarone DIONYSOS have clearly proven it , to be a less effective agent in controlling AF , but has a advantage of fewer adverse effects.
Hence , for preventing the potential side effects of Amiodarone , let our patients take an inefficient drug ! This is how we are inclined to think ! But the medical industry can not be blamed altogether , after years of research they develop a molecule and they would like to have at least a small pie in the atrial fibrillation market place !
It again proves the centuries old adage, that all drugs are poisons .If a drug lacks side effects it ceases to have the desired effect also . If you want a drug with zero side effect a sugar coated placebo is the best choice !
Is there really a role for Dronedarone ?
Yes , may be in patients who have recurrent AF in spite of stabilising the underlying conditions that perpetuate AF( Hypertension, CAD, COPD etc)
When Amiodarone is contraindicated or withdrawn due to side effects
Remember , Digoxin, Beta blockers, or even calcium blockers , can have an important role in the chronic management of AF. But they are unpopular for many reasons other than academics!
Dronedarone is power-less antiarrhythmic drug ( “Less- powerful ” could be a more polite and decent word !) that has a specific role in the management of AF when efficient rate or rhythm control is deemed unnecessary !
Why don’t we have study with one to one comparison of Digoxin ,Beta blocker and Dronedarone in the chronic management of atrial fibrillation !