Midodrine hydrochloride as a treatment for postural orthostatic tachycardia syndrome: A systematic review and meta-analysis - PubMed
6 hours ago
- #midodrine
- #systematic review
- #POTS treatment
- The systematic review and meta-analysis evaluates midodrine hydrochloride for treating postural orthostatic tachycardia syndrome (POTS), including 14 studies (2000-2017) with 968 patients.
- In pediatric studies, midodrine significantly increased odds of symptom response versus control (RR 1.52, 95%CI 1.09-2.13, p=0.01) and showed a 1.16-fold increase versus beta-blockers (RR 1.16, 95%CI 1.02-1.32, p=0.02).
- Adverse events included hypertension in 8.2% of patients and gastrointestinal disturbance in 3.4%, but evidence on efficacy is limited, especially in adults.
- Midodrine may be considered as second- or third-line therapy for symptomatic patients needing enhanced vascular tone or preload, but its use in older hypertensive patients should be discouraged.
- The review calls for additional studies to better identify which patients benefit most from midodrine treatment.