Serial lung function testing in patients treated with Amiodarone: A prospective study
Key result
Amiodarone carries a ~5% pulmonary toxicity rate, but isolated DLCO drops poorly predict clinical disease.
- n=91
Why the study?
Pulmonary toxicity is a possible side effect of amiodarone with a reported incidence of 2 to 15 percent per year, necessitating evaluation of its effect on lung function.
Does amiodarone treatment cause an accelerated decline in lung function in patients with refractory cardiac arrhythmias?
Population
91 patients with refractory cardiac arrhythmias treated with amiodarone
Comparison
Serial lung function tests over time during amiodarone therapy
Design
Prospective cohort study
Follow-up
Mean 351 days
Authors
Discussion
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Implication
Isolated DLCO declines should not prompt amiodarone discontinuation in asymptomatic patients; leaves open prospective validation of monitoring thresholds.
Study Design
Type
Cohort (n=91)
Structured PICO
Does amiodarone treatment cause an accelerated decline in lung function in patients with refractory cardiac arrhythmias?
P
Population
91 patients with refractory cardiac arrhythmias treated with amiodarone, followed for a mean of 351 days.
E
Exposure
Amiodarone (mean dose 367 mg daily, range: 136 to 512 mg)
O
Outcome
Changes in spirometry and carbon monoxide diffusing capacity (DLCO) measured at zero, three, six, 12, 18, and 24 monthssafety
An isolated fall in DLCO without clinical symptoms has a low positive predictive value for amiodarone pulmonary toxicity and does not necessitate stopping the drug.
Cite This Study
Gleadhill et al. (1989) conducted a cohort in refractory cardiac arrhythmias (n=91). Amiodarone was evaluated on clinically evident amiodarone pulmonary toxicity. Amiodarone therapy was associated with clinical pulmonary toxicity in 4.5% of patients, and an isolated fall in DLCO >20% had a positive predictive value of only 21% for clinical toxicity.