Carl Hayward1, Hitesh C Patel2, Ketna Patel3, Carlo Di Mario2, Alexander R Lyon2, Syed Y Ahsan4, Edward Rowland4. 1. NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK c.hayward@rbht.nhs.uk. 2. NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. 3. University College London, London, UK. 4. Barts Heart Centre, London, UK.
Abstract
AIMS: An important decision in the management of patients with atrial fibrillation is whether to adopt a rate or rhythm control strategy. Options for the latter include oral membrane-active anti-arrhythmic drugs (AADs) or catheter ablation. Recent prescription trends may have been affected by the introduction of dronedarone and an increasing number of reports suggesting increased mortality in those taking AADs. We describe the trend in oral AAD prescriptions in England in the period 1998-2014. METHODS AND RESULTS: We conducted a retrospective study using data from the Prescription Cost Analysis system, which holds information on every prescription dispensed in the community in England. We obtained data from 1998 to October 2014 for all Class Ia, Ic, and III AADs. Amiodarone and sotalol remain the most commonly prescribed AADs in England, though the use of both is decreasing. There has been a linear increase in the uptake of flecainide. Dronedarone prescriptions peaked in 2011, and our most recent data show that amiodarone prescriptions are 25-fold those of dronedarone. CONCLUSION: There is a decline in the use of amiodarone and sotalol consistent with the growing safety concerns with these drugs along with neutral results from landmark trials comparing rate and rhythm control. Dronedarone has failed to make an impact on AAD prescribing. In contrast, flecainide has seen an increase in use during the study period. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: An important decision in the management of patients with atrial fibrillation is whether to adopt a rate or rhythm control strategy. Options for the latter include oral membrane-active anti-arrhythmic drugs (AADs) or catheter ablation. Recent prescription trends may have been affected by the introduction of dronedarone and an increasing number of reports suggesting increased mortality in those taking AADs. We describe the trend in oral AAD prescriptions in England in the period 1998-2014. METHODS AND RESULTS: We conducted a retrospective study using data from the Prescription Cost Analysis system, which holds information on every prescription dispensed in the community in England. We obtained data from 1998 to October 2014 for all Class Ia, Ic, and III AADs. Amiodarone and sotalol remain the most commonly prescribed AADs in England, though the use of both is decreasing. There has been a linear increase in the uptake of flecainide. Dronedarone prescriptions peaked in 2011, and our most recent data show that amiodarone prescriptions are 25-fold those of dronedarone. CONCLUSION: There is a decline in the use of amiodarone and sotalol consistent with the growing safety concerns with these drugs along with neutral results from landmark trials comparing rate and rhythm control. Dronedarone has failed to make an impact on AAD prescribing. In contrast, flecainide has seen an increase in use during the study period. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Raluca Ionescu-Ittu; Michal Abrahamowicz; Cynthia A Jackevicius; Vidal Essebag; Mark J Eisenberg; Willy Wynant; Hugues Richard; Louise Pilote Journal: Arch Intern Med Date: 2012-07-09
Authors: Isabelle C Van Gelder; Vincent E Hagens; Hans A Bosker; J Herre Kingma; Otto Kamp; Tsjerk Kingma; Salah A Said; Julius I Darmanata; Alphons J M Timmermans; Jan G P Tijssen; Harry J G M Crijns Journal: N Engl J Med Date: 2002-12-05 Impact factor: 91.245
Authors: Lars Køber; Christian Torp-Pedersen; John J V McMurray; Ole Gøtzsche; Samuel Lévy; Harry Crijns; Jan Amlie; Jan Carlsen Journal: N Engl J Med Date: 2008-06-19 Impact factor: 91.245
Authors: D S Echt; P R Liebson; L B Mitchell; R W Peters; D Obias-Manno; A H Barker; D Arensberg; A Baker; L Friedman; H L Greene Journal: N Engl J Med Date: 1991-03-21 Impact factor: 91.245
Authors: Paulus Kirchhof; Bettina Ammentorp; Harald Darius; Raffaele De Caterina; Jean-Yves Le Heuzey; Richard John Schilling; Josef Schmitt; Jose Luis Zamorano Journal: Europace Date: 2013-10-01 Impact factor: 5.214
Authors: Odilia I Woudstra; Joey M Kuijpers; Monique R M Jongbloed; Arie P J van Dijk; Gertjan T Sieswerda; Hubert W Vliegen; Anastasia D Egorova; Philippine Kiès; Anthonie L Duijnhouwer; Daniëlle Robbers-Visser; Thelma C Konings; Aeilko H Zwinderman; Folkert J Meijboom; Barbara J M Mulder; Berto J Bouma Journal: Eur Heart J Cardiovasc Pharmacother Date: 2022-01-05