Droxidopa for orthostatic hypotension: a systematic review and meta-analysis

被引:13
|
作者
Strassheim, Victoria [1 ]
Newton, Julia L. [1 ,2 ]
Tan, Maw Pin [3 ]
Frith, James [1 ,2 ]
机构
[1] Newcastle Tyne Hosp NHS Fdn Trust, Newcastle Upon Tyne, Tyne & Wear, England
[2] Newcastle Univ, Inst Cellular Med, Sch Med, 4th Floor William Leech, Newcastle Upon Tyne, Tyne & Wear, England
[3] Univ Malaya, Dept Med, Ageing & Age Associated Disorders Res Grp, Fac Med, Kuala Lumpur, Malaysia
基金
美国国家卫生研究院;
关键词
droxidopa; meta-analysis; orthostatic hypotension; systematic review; PARKINSONS-DISEASE; PRECURSOR THERAPY; MANAGEMENT; PLACEBO; L-THREO-3,4-DIHYDROXYPHENYLSERINE; PREVENTION; PREVALENCE; MIDODRINE; EFFICACY; ATROPHY;
D O I
10.1097/HJH.0000000000001043
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objective:The systematic review and meta-analysis aims to determine the efficacy and safety of droxidopa in the treatment of orthostatic hypotension, following its recent approvals in the United States.Methods:MEDLINE, EMBASE, PubMed, Cochrane Controlled Trials Register, Web of Science, ProQuest, and the WHO Clinical Trials Registry were searched. Studies were included if they randomized adults with orthostatic hypotension to droxidopa or to control, and outcomes related to symptoms, daily activity, blood pressure, or adverse events. Data were extracted independently by two reviewers. Risk of bias was judged against the Cochrane risk of bias tool and quality of evidence measured using Grading of Recommendations Assessment, Development and Evaluation criteria. A fixed-effects model was used for pooled analysis.Results:Of 224 identified records, four studies met eligibility, with a pooled sample size of 494. Study duration was between 1 and 8 weeks. Droxidopa was effective at reducing dizziness [mean difference -0.97 (95% confidence interval -1.51, -0.42)], overall symptoms [-0.52 (-0.98, -0.06)] and difficulty with activity [-0.86 (-1.34, -0.38)]. Droxidopa was also effective at improving standing SBP [3.9 (0.1, 7.69)]. Rates of adverse events were similar between droxidopa and control groups, including supine hypertension [odds ratio 1.93 (0.87, 4.25)].Conclusion:Droxidopa is well tolerated and effective at reducing the symptoms associated with neurogenic orthostatic hypotension without increasing the risk of supine hypertension.Registration: PROSPERO ID CRD42015024612
引用
收藏
页码:1933 / 1941
页数:9
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