Abstract P104: Higher Cost Burden of Adverse Events With Amiodarone Compared to Other Antiarrhythmics in Atrial Fibrillation Patients in the United States

Introduction: Real-world data on the incidence of adverse events (AEs) associated with antiarrhythmic drugs (AADs) are limited. We compared the frequency of AEs/AE monitoring for organ toxicity in atrial fibrillation (AF) patients receiving amiodarone versus other AADs. Methods: In this retrospective cohort study, patients ≥18 years with AF (indicated by ≥1 AF hospital discharge or ≥2 non-diagnostic outpatient AF claims) and ≥18 months' continuous enrollment data between Jan 2003 and Sept 2007 were identified from the US MarketScan® database. Patients were required to be continuously enrolled for ≥12 months preceding and for ≥6 months following their first qualifying (index) AF diagnosis. For those patients undergoing ≥3 months of antiarrhythmic therapy, the frequency of AEs/AE monitoring after the index diagnosis was assessed from hospital/outpatient visits linked to specified diagnostic testing codes/procedures (Table). Results: In total, 20,051 AF patients (mean 73 years; 58% men) received amiodarone and 19,710 (mean 68 years; 55% men) received other AADs (mainly sotalol, propafenone and flecainide) [mean (±SD) duration of continuous enrollment 43.4 ± 13.2 vs 42.5 ± 14.0 months, respectively). Amiodarone-treated patients had higher incidences of HF [41% (n=8,184) vs 17% (n=3,315)], diabetes [25% (n=5,014) vs 18% (n=3,634)] and CAD [17% (n=3,405) vs 11% (n=2,095)] than those on other AADs. Diagnostic testing/procedures and hospital admissions potentially associated with AEs (including thyroid and pulmonary function testing, dermatologic, ocular and chest x-ray examination, cardioversion and admissions for ventricular arrhythmia) occurred in a significantly higher proportion of patients on amiodarone compared with other AADs, and related costs were higher with amiodarone (Table). Conclusions: In clinical practice, AF patients on amiodarone experienced higher AEs/AE monitoring burden and costs than those on other AADs. 1 ![Graphic][1] 2 [1]: /embed/inline-graphic-1.gif