Cardiome Announces Presentation at Medical Conference and Provides Update on Journal Publications for Vernakalant

 Cardiome Announces Presentation at Medical Conference and Provides Update on
                     Journal Publications for Vernakalant

  PR Newswire

  VANCOUVER, British Columbia, October 28, 2013

VANCOUVER, British Columbia, October 28, 2013 /PRNewswire/ --

NASDAQ: CRME

TSX : COM

Cardiome Pharma Corp. (NASDAQ: CRME) (TSX: COM) today announced that the
abstract, Conversion of Acute Atrial Fibrillation with Propafenone or
Vernakalant , is being presented as an oral presentation by Dr. Diego Conde,
Chief of Cardiovascular Emergency Care Section, Instituto Cardiovascular de
Buenos Aires, at the Venice Arrhythmias meeting, being held in Venice, Italy,
October 27-29, 2013. This abstract is competing for the Geographical Areas
Special Best Abstract Award - Latin America. Cardiome is also providing an
update on journal publications by Dr. Conde of comparative studies for
intravenous (IV) vernakalant in the treatment of atrial fibrillation (AF)
versus other antiarrhythmic medications and electrical cardioversion.

"This series of publications led by Dr. Conde reinforces the key
differentiating characteristics of vernakalant IV compared to other therapies
available for conversion," stated Steen Juul-Möller, M.D., Medical Director at
Cardiome Pharma Corp. "His real-life observations using vernakalant IV with
respect to time required for therapeutic effect, efficacy, safety and length
of stay in the emergency room are very encouraging."

"Our experience using vernakalant IV has been extremely satisfying," stated
Diego Conde, M.D., Chief of Cardiovascular Emergency Care Section, Instituto
Cardiovascular de Buenos Aires. "In our center, the use of oral propafenone or
flecainide is fairly common. However, with the comparable efficacy and safety
seen with vernakalant IV, coupled with a reduction in hospital length of stay,
I believe vernakalant IV is a compelling and viable therapeutic option for the
conversion of recent-onset AF in our institution."

In May 2013, the publication Propafenone Versus Vernakalant for Conversion of
Recent-Onset Atrial Fibrillation authored by Dr. Conde et al., appeared in the
advanced online article access of Cardiovascular Therapeutics, a peer reviewed
medical journal, and represents the first study to compare these two agents.
^[ ^1 ^] This study was an open label, sequential design study in patients
with atrial fibrillation of less than 48 hours duration that contrasted
treatment with vernakalant intravenous (N=17) to oral propafenone (N=19).
Subjects received a single oral dose of 600 mg of propafenone or vernakalant
IV in an initial dose of 3.0 mg/kg for 10 minutes and an additional 2 mg/kg if
AF had not resolved within 15 minutes, which is in accordance with the
approved dosage recommendation. Patients treated with vernakalant achieved
conversion to normal sinus rhythm in a median time of 9 minutes versus 166
minutes in the propafenone group (p<0.01). Conversion rate was 78% in the
propafenone group at 8 hours and 93% in the vernakalant group at 2 hours
(p=NS). In addition to the more rapid time to cardioversion, patients treated
with vernakalant IV experienced a significantly shorter hospital length of
stay, 238 minutes versus 416 minutes (p<0.01) for patients treated with
propafenone. There was one serious adverse event (transient bradycardia) in
each treatment group.

Another publication titled Flecainide versus Vernakalant for Conversion of
Recent-Onset Atrial Fibrillation authored by Dr. Conde et al., and published
online in March 2013 in the peer-reviewed International Journal of Cardiology,
showed that the time to conversion to sinus rhythm was 163 minutes in the
flecainide group (300 mg single oral dose, N = 15) versus 10 minutes in the
vernakalant IV group (labeled dose, N=17) (p<0.01) in patients with AF
duration less than 48 hours. ^[ ^2 ^] In this open-label study, patients
treated with vernakalant IV experienced a significantly shorter hospital
length of stay, 232 minutes versus 409 minutes (p<0.01) for the patients
treated with flecainide. The conversion rate for patients treated with
vernakalant at 2 hours was 86% compared to 78% for patients treated with
flecainide at 8 hours (p=NS). There was one serious adverse event (transient
bradycardia) in each treatment group.

Furthermore, a study in patients with AF of less than 48 hours duration who
were treated with vernkalant IV had a statistically significant improvement in
perception of state of health at 2 hours compared with propafenone or
flecainide. Based on the EQ-5D quality of life (QoL) instrument, a mean
increase of 12.1 points from baseline was seen in the vernakalant IV group
while the mean increases were 5.4 points in the propafenone and 5.2 points in
the flecainide group (p<0.01). ^[ ^3 ^] These changes in QoL measured at 2
hours after treatment were consistent with the rapid conversion time seen in
the vernakalant IV group. The full study is published online in the Cardiology
Journal.

A short-communication authored by Dr. Conde et al., published online in the
International Journal of Cardiology in July 2013, titled Vernakalant versus
Electrical Cardioversion in Recent-Onset Atrial Fibrillation , concluded that
the conversion rate of recent-onset AF and hospital length of stay was similar
in patients treated with vernakalant or electrical cardioversion without
statistical differences. ^[ ^4 ^] The authors further stated that where
electrical cardioversion protocols included the need for sedation and fasting
for a minimum of 3 to 6 hours, vernakalant was found to be a safe and
effective alternative to electrical cardioversion in this population. This
observational study included hemodynamically stable, recent-onset AF of less
than 48 hours duration without structural heart disease. Electrical
cardioversion was performed in 30 patients and another 30 patients received
the labeled dose of vernakalant IV. All electrical cardioversions were
performed under sedation with intravenous propafol and with a minimum of 3
hours fasting. Conversion rate was 91% in the vernakalant group at 2 hours and
100% in the electrical cardioversion group (p=NS). Hospital length of stay was
246 minutes in the vernakalant group compared to 263 minutes in the electrical
cardioversion group (p=NS). No adverse events were reported.

References:

1.Conde, D. et al. Propafenone versus vernakalant for conversion of
    recent-onset atrial fibrillation. Cardiovascular Therapeutics. Advance
    access published May 20, 2013, doi:10.1111/1755-5922.12036
2.Conde, D. et al. Flecainide versus vernakalant for conversion of
    recent-onset atrial fibrillation. International Journal of Cardiology.
    Advance access published Mar 21, 2013, doi: 10.1016/j.ijcard.2013.02.006
3.Conde, D. et al. Vernakalant: Perception of state of health in patients
    with a recent-onset atrial fibrillation. Cardiology Journal. Advance
    access published Jul 23, 2013, doi: 10.5603/CJ.a2013.0113
4.Conde, D. et al. Vernakalant versus electrical cardioversion in
    recent-onset atrial fibrillation. International Journal of Cardiology.
    Advance Access published Jul 26, 2013, doi: 10.1016/j.ijcard.2013.06.055

About Cardiome Pharma Corp.

Cardiome Pharma Corp. is a biopharmaceutical company dedicated to the
discovery, development and commercialization of new therapies that will
improve the health of patients around the world. Cardiome has one marketed
product, BRINAVESS ^TM (vernakalant IV), approved in Europe and other
territories for the rapid conversion of recent onset atrial fibrillation to
sinus rhythm in adults.

Cardiome is traded on the NASDAQ Capital Market (CRME) and the Toronto Stock
Exchange (COM). For more information, please visit our web site at
http://www.cardiome.com .

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