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Lookup NU author(s): Vicki Strassheim, Emerita Professor Julia Newton, Dr Maw Tan, Dr James FrithORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
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
Author(s): Strassheim V, Newton JL, Tan MP, Frith J
Publication type: Review
Publication status: Published
Journal: Journal of Hypertension
Year: 2016
Volume: 34
Issue: 10
Pages: 1933-1941
Print publication date: 01/10/2016
Acceptance date: 01/01/1900
ISSN (print): 0263-6352
ISSN (electronic): 1473-5598
Publisher: LIPPINCOTT WILLIAMS & WILKINS
URL: http://dx.doi.org/10.1097/HJH.0000000000001043
DOI: 10.1097/HJH.0000000000001043
