Risultati per: Dronedarone

Circulation, Volume 146, Issue Suppl_1, Page A15002-A15002, November 8, 2022. Introduction:Catheter ablation is used increasingly as a 1st-line (1L) alternative to antiarrhythmic drugs (AAD) including dronedarone in patients with atrial fibrillation (AF). Healthcare resource utilization (HCRU)-related costs with dronedarone vs 1L ablation are unknown.Methods:We conducted a retrospective, observational cohort study using Optum Clinformatics Data Mart® from Jan 2012-Jan 2022 among US adults with AF and no prior rhythm control therapy who received new AAD therapy with dronedarone (index: date of incident dronedarone fill) vs those who received 1L ablation, or a non-dronedarone AAD followed by ablation within 3 mo (index: date of first recorded ablation or AAD). Patients were required to have ≥24 mo of pre-index data, and ≥3 mo follow-up. Patients in the 1L ablation cohort were propensity score matched 2:1 to the dronedarone cohort. Mean payer costs per patient per month (PPPM) during the 24-mo post-index period were calculated for total HCRU, inpatient visits, emergency room (ER) visits, outpatient physicians’ office visits, and all outpatient visits, and compared by zero-inflated negative binomial (ZINB) regression model.Results:Post-matching, the dronedarone (n=1440) and 1L ablation (n=2253) cohorts had similar baseline characteristics (mean age at index: 68.4 vs 67.7 years; male: 57.7% vs 59.3%; mean time from AF diagnosis to index: 80.2 vs 91.6 days; Charlson comorbidity index: 2.3 vs 2.2; CHADS2-VASc score: 3.4 vs 3.2). Mean PPPM costs were lower with dronedarone vs 1L ablation for all-cause total HCRU, inpatient visits, any outpatient visit, ER visit, and outpatient office visit (Table). ZINB analyses showed significant cost differences for all-cause total HCRU and any outpatient visit events.Conclusion:In patients with AF and no prior rhythm control therapy, 1L dronedarone was associated with lower total HCRU and outpatient visit costs during 24-mo follow-up vs 1L ablation; future studies will assess cost-effectiveness.

Circulation, Volume 146, Issue Suppl_1, Page A13500-A13500, November 8, 2022. Introduction:Dronedarone has shown clinical benefit vs sotalol in adults with atrial fibrillation (AF) post-ablation, but healthcare resource utilization (HCRU) in this setting is unknown.Methods:A retrospective, observational cohort study was conducted using IBM MarketScan® data (Jan 2012-Mar 2020) in adults with AF receiving dronedarone or sotalol post-ablation. Patients needed to have 12 months of pre-ablation data; follow-up ended at earliest of health-plan disenrollment, death or end of study (Dec 2020). Prevalence (events per 100 patient-years [PY]) was calculated for all-cause and cardiovascular (CV)-related HCRU (hospitalizations; emergency room [ER] visits; outpatient office visits; other outpatient services). Patients receiving sotalol were propensity score (PS)-matched 1:1 to patients receiving dronedarone and compared by univariate generalized linear models with Poisson distribution. Time-to-event (TTE) cumulative incidences for all-cause, CV-related and atrial tachyarrhythmia (ATA)-/AF-related hospitalization, and for pacemaker insertion, were compared by Kaplan-Meier analysis and log rank test.Results:After PS-matching, the dronedarone and sotalol (n=1600 per cohort) cohorts were successfully matched across several criteria (mean follow-up: ~28 months; age at ablation: ~61 years; proportion male: ~70%; hypertension: ~71%; heart failure: ~13%; mean CHA2DS2-VASc score: ~1.8; mean Charlson comorbidity index: ~0.8). Post-ablation, prevalence per 100 PY of all-cause hospitalization (24.0 vs 27.4), ER visits (53.1 vs 59.5) and other outpatient services (1140.1 vs 1184.5), and of CV-related hospitalization (8.4 vs 11.3), ER visits (8.5 vs 10.0) and outpatient office visits (379.6 vs 390.9), were significantly lower with dronedarone vs sotalol. Cumulative incidences were significantly lower with dronedarone vs sotalol (Figure).Conclusions:Post-ablation dronedarone was associated with lower HCRU vs sotalol.

Circulation, Volume 146, Issue Suppl_1, Page A13528-A13528, November 8, 2022. Introduction:Patterns of anti-arrhythmic drug therapy for atrial fibrillation (AF) treatment and outcomes may differ by sex. Dronedarone has shown clinical benefit vs sotalol post-ablation in males and females with AF; however, the impact of these drugs on healthcare resource utilization (HCRU) remains unknown among sex subgroups.Methods:We conducted two retrospective, observational cohort analyses using IBM MarketScan® data (Jan 2012-Mar 2020) in adult male and female patients with AF who received dronedarone or sotalol post-ablation. Patients were required to have had 12 months’ available pre-ablation data; follow-up ended at the earliest of health-plan disenrollment, death or end of data availability (Dec 2020). Prevalence (per 100 patient-years [PY]) during the post-ablation period was calculated for all-cause HCRU (hospitalizations; emergency room [ER] visits; outpatient office visits; other outpatient services). Patients receiving sotalol were propensity score matched 1:1 to patients receiving dronedarone and outcomes were compared using univariate generalized linear models with Poisson distribution.Results:In females (n=460 per cohort ; age at ablation: ~64 years; mean follow-up: ~29 months; prior heart failure: ~14.6%; mean Charlson comorbidity index [CCI]: ~0.8), post-ablation prevalence of ER visits, outpatient office visits, and other outpatient services were significantly lower with dronedarone than sotalol (Table). In males (n=1112 per cohort; age at ablation: ~60 years; mean follow-up: ~29 months; prior heart failure: ~12%; mean CCI: ~0.8), post-ablation prevalence of hospitalizations was significantly lower with dronedarone than sotalol, but other HCRU measures were similar.Conclusions:In females post-AF ablation, dronedarone was generally associated with lower HCRU than sotalol. In males, dronedarone was associated with lower hospitalization prevalence than sotalol, but other HCRU was similar.