Abstract
Clinical trials support dronedarone use for atrial fibrillation (AF) following catheter ablation (CA); however, comparative data on health care resource utilization (HCRU) with other antiarrhythmic drugs are lacking.BACKGROUNDClinical trials support dronedarone use for atrial fibrillation (AF) following catheter ablation (CA); however, comparative data on health care resource utilization (HCRU) with other antiarrhythmic drugs are lacking.Retrospective analysis of Merative MarketScan databases (January 01, 2012-March 31, 2020) comparatively assessed HCRU in US adults with AF who received dronedarone or sotalol post-CA. Patients with ≥ 12-months' pre-CA data were followed from post-CA index treatment to disenrollment, death, or study end. Sotalol-treated patients were propensity score-matched (1:1) with dronedarone-treated patients. Events/100 patient-years (PY) were analyzed by univariate generalized-linear model with Poisson distribution. Cumulative incidence was analyzed over 12 months by Kaplan-Meier methods. Subgroup analyses were conducted by sex and patients new to dronedarone or sotalol during 12 months pre-CA.METHODSRetrospective analysis of Merative MarketScan databases (January 01, 2012-March 31, 2020) comparatively assessed HCRU in US adults with AF who received dronedarone or sotalol post-CA. Patients with ≥ 12-months' pre-CA data were followed from post-CA index treatment to disenrollment, death, or study end. Sotalol-treated patients were propensity score-matched (1:1) with dronedarone-treated patients. Events/100 patient-years (PY) were analyzed by univariate generalized-linear model with Poisson distribution. Cumulative incidence was analyzed over 12 months by Kaplan-Meier methods. Subgroup analyses were conducted by sex and patients new to dronedarone or sotalol during 12 months pre-CA.Dronedarone and sotalol cohorts were successfully matched (n = 1600 each). Prevalence/100-PY for all-cause, cardiovascular (CV)-related, and atrial tachyarrhythmia (ATA)/AF-related HCRU was lower in dronedarone versus sotalol cohort (all p < 0.05). Cumulative incidence for all-cause, CV-related, ATA/AF-related hospitalizations, and pacemaker implantation was lower in dronedarone versus sotalol cohort (all p < 0.05). Incidence of all-cause and CV-related hospitalizations was lower in dronedarone versus sotalol cohorts in females (n = 460) and males (n = 1115) (all p < 0.05) after rematching. Incidence of ATA/AF-related hospitalization was lower in males versus females receiving dronedarone. For patients new to dronedarone or sotalol (n = 549), HCRU results were generally consistent with primary analyses.RESULTSDronedarone and sotalol cohorts were successfully matched (n = 1600 each). Prevalence/100-PY for all-cause, cardiovascular (CV)-related, and atrial tachyarrhythmia (ATA)/AF-related HCRU was lower in dronedarone versus sotalol cohort (all p < 0.05). Cumulative incidence for all-cause, CV-related, ATA/AF-related hospitalizations, and pacemaker implantation was lower in dronedarone versus sotalol cohort (all p < 0.05). Incidence of all-cause and CV-related hospitalizations was lower in dronedarone versus sotalol cohorts in females (n = 460) and males (n = 1115) (all p < 0.05) after rematching. Incidence of ATA/AF-related hospitalization was lower in males versus females receiving dronedarone. For patients new to dronedarone or sotalol (n = 549), HCRU results were generally consistent with primary analyses.Post-CA dronedarone, versus sotalol, lowered CV-related HCRU in all-comers with AF and in sex subgroups. Findings may contribute to clinical decision making post-CA in patients with AF.CONCLUSIONPost-CA dronedarone, versus sotalol, lowered CV-related HCRU in all-comers with AF and in sex subgroups. Findings may contribute to clinical decision making post-CA in patients with AF.