Study: Sanofi's Multaq shouldn't be a first-line drug

Researchers have dealt another blow to the new Sanofi-Aventis drug Multaq. Approved to treat atrial fibrillation, Multaq proved less effective and no safer than its chief rival, a Cedars-Sinai Heart Institute study finds, and its authors recommend against first-line treatment with the drug. But a commentary in the same journal disagrees, saying Multaq should be a first choice for low-risk patients because of the volume of data on its safety.

The Cedars-Sinai study, which was published in the Journal of the American College of Cardiology, concludes Multaq is 50 percent less effective than rival drug amiodarone, which is sold under several brand names including Cordarone, Reuters reports. "We believe that [Multaq] should only be used as a second-line or third-line agent in individuals [who] are not able to tolerate amiodarone or other first-line agents," lead author Dr. Sanjay Kaul says (as quoted by the news service).

But the commentary disagrees with this assessment. Written by University of Copenhagen cardiologist Dr. Christian Torp-Pedersen, the companion piece notes that while Multaq shouldn't be used in patients with severe heart failure, it's the only drug proven reasonably safe for patients on the lower end of the risk scale.

Multaq's safety and efficacy have been up for debate recently as governments determine whether to pay for the drug--as well as how much they're willing to fork over. The U.K.'s cost-effectiveness watchdog approved the drug after deciding that, while it was no more effective than rival meds, it did appear to be safer. Meanwhile, in France, reports have surfaced that officials plan to reimburse only 35 percent of its cost. This debate isn't over yet, and because Multaq is so important to Sanofi's revenue-building strategy, we'll be following it closely.

- read the Reuters story
- get the abstract for the JACC study