The National Institute for Health and Clinical Excellence (NICE) is currently appraising the use of dronedarone (Multaq) for the treatment of atrial fibrillation (AF) – a disturbance of the heart’s rhythm.
After considering comments received at public consultation on the previous draft guidance, the independent Appraisal Committee has revised its original recommendation that the drug should not be used to treat atrial fibrillation. Further draft guidance now published recommends the limited use of the drug as a second-line treatment in people with additional cardiovascular risk factors whose AF has not been controlled by first-line therapy (usually including beta-blockers). Although the Committee did not change their conclusion that dronedarone is not as effective as other anti-arrhythmic drugs in preventing the recurrence of AF, it accepted evidence that the drug did not lead to an increase in the risk of mortality, unlike the anti-arrhythmics with which it was compared. The Committee also noted comments from patients and clinical experts received during consultation on the previous draft that all current anti-arrhythmic drugs, but particularly amiodarone, had side effects which had a significant impact on quality of life with long-term use. Overall, the Committee concluded that dronedarone was likely to result in fewer adverse effects than amiodarone.
