Antiarrhythmic drugs, patients, and the pharmaceutical industry: value for patients, physicians, pharmacists or shareholders?
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Antiarrhythmic drugs no longer seem to be big business. After the unexpected CAST trial results (excess mortality in the class 1C antiarrhythmic drug treatment arms in patients with coronary artery disease (CAD) and abundant ventricular extrasystoles),1 antiarrhythmic drug treatment became less popular for CAD patients. Since this category of patients represents the majority of cardiology patients with chronic disease, these results impacted on the antiarrhythmic drug market. In the years that followed, the use of class 1C drugs was even further discouraged.
KeywordsQuinidine Antiarrhythmic Drug Disopyramide Coronary Artery Disease Patient Procainamide
- The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989;321:406-12.Google Scholar
- Effect of prophylactic amiodarone on mortality after acute myocardial infarction and in congestive heart failure: meta-analysis of individual data from 6500 patients in randomised trials. Amiodarone Trials Meta-Analysis Investigators. Lancet 1997;350:1417-24.Google Scholar
- Dorian P, Borggreve M, Al-Khalidi, et al. Placebo-controlled, randomized clinical trial of azimilide for prevention of ventricular tachyarrhythmias in patients with an implantable cardioverter defibrillator. Circulation 2004;110:3646-54.Google Scholar
- Jongman J, Jepkes-Bruin N, Ramdat Misier AR, Beukema WP, Delnoy PPHM, Oude Luttikhuis H, et al. Electrical storms in Brugada syndrome successfully treated with isoprenaline infusion and quinidine orally. Neth Heart J 2007,15:151-4.Google Scholar
- Belhassen B, Glick A, Viskin S. Efficacy of quinidine in high-risk patients with Brugada syndrome. Circulation 2004;110:1731-7. Google Scholar
- Matsuo K, Kurita T, Inagaki M, et al. The circadian pattern of the development of ventricular fibrillation in patients with Brugada syndrome. Eur Heart J 1999;20:465-70.Google Scholar