Amiodarone induced pulmonary toxicity: An epidemiologic study

Abstract

Background Amiodarone is a powerful antiarrhythmic drug. However amiodarone pulmonary toxicity(APT) is often life threatened and limits its usage. The purpose of this study is to clarify the incidence rate, risk factors of APT and effectiveness of screening tests. Methods 500 patients were investigated. The incidence of APT was estimated by Kaplan-Meier method. Age, pulmonary diffusion capacity(DLco), body mass index(BMI), serum creatinine and albumin concentrations, loading and maintenance doses were analyzed using Cox's proportional hazard model. We have monitored DLco and KL-6 every three months to predict APT (a decrease in DLco>20%, more than 500U/ml of KL-6 defined as positive) during amiodarone therapy. We also evaluate the efficacy of these parameters as screening test. Results Follow up period was 4.5±3.7 year, and maintenance dose was 137±61mg/day. The cumulative incidence rate of APT in five years was 7.5% (1.5% per year). Age and maintenance doses could be identified as risk factors for APT. Evaluations of both screening tests were as follows (sensitivity, specificity): DLco (84%, 73%), KL-6 (8%, 91%). ROC curve of DLco was superior to KL-6. Conclusions The incident rate of APT was 1.5% per year and measuring of DLco every three months may be useful to predict APT. Clinical Pharmacology & Therapeutics (2005) 77, P71–P71; doi: 10.1016/j.clpt.2004.12.162 Figure 1Open in figure viewerPowerPoint