Evidence map›Paper›PMID 24729712›Full record

ReviewVascular health and risk management2014

Neurogenic orthostatic hypotension in Parkinson's disease: evaluation, management, and emerging role of droxidopa.

Stuart H Isaacson, Julia Skettini

Registry-linked trialOpen access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Vascular health and risk management, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03602014 (Dose Response to the Norepinephrine Precursor Droxidopa in Hypotensive Individuals With Spinal Cord Injury), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
5.3field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03602014 phase4completednot on this mapstarted 2018, after this paper: background citation

Dose Response to the Norepinephrine Precursor Droxidopa in Hypotensive Individuals With Spinal Cord Injury

TypeinterventionalSponsorJames J. Peters Veterans Affairs Medical CenterRan2018 to 2021Enrolled22ConditionsHypotension, Orthostatic, Hypotension, Spinal Cord InjuriesArmsNorthera, Placebo
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

  1. Meta-analysis of the safety and efficacy of droxidopa for neurogenic orthostatic hypotension.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2016
    Pooled it
  2. Review
  3. Observational
  4. Review
  5. Review
  6. Article
  7. Article
  8. Review
  9. Article
  10. Review
  11. Article
  12. Observational
  13. Article
  14. Review
  15. Review
  16. Parkinson's disease between internal medicine and neurology.Journal of neural transmission (Vienna, Austria : 1996) · 2016
    Review
  17. Clinical Relevance of Orthostatic Hypotension in Neurodegenerative Disease.Current neurology and neuroscience reports · 2015
    Review
  18. Orthostatic hypotension: managing a difficult problem.Expert review of cardiovascular therapy · 2015
    Review
  19. Review
  20. Designer receptors enhance memory in a mouse model of Down syndrome.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2015
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Stuart H IsaacsonParkinson's Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA.
Julia SkettiniParkinson's Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA.
Parkinson's Research and Education Foundation · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Neurogenic orthostatic hypotension (nOH) is due to failure of the autonomic nervous system to regulate blood pressure in response to postural changes due to an inadequate release of norepinephrine, leading to orthostatic hypotension and supine hypertension. nOH is common in Parkinson's disease (PD). Prevalence varies throughout the course of PD, ranging from 40% to 60%, and resulting in symptomatic nOH in approximately half. Symptomatic nOH, including lightheadedness, can limit daily activities and lead to falls. Symptomatic nOH can also limit therapeutic options for treating PD motor symptoms. Clinical evaluation should routinely include symptom assessment and blood pressure measurement of supine, sitting, and 3-minute standing; 24-hour ambulatory blood pressure monitoring can also be helpful. Non-pharmacological management of symptomatic nOH involves education, physical maneuvers, and adequate hydration. Current pharmacological treatment of symptomatic nOH includes salt supplement, fludrocortisone, midodrine, pyridostigmine, and other empiric medications. Despite these options, treatment of symptomatic nOH remains suboptimal, often limited by severe increases in supine blood pressure. Droxidopa, an oral prodrug converted by decarboxylation to norepinephrine, is a promising therapeutic option for symptomatic nOH in PD, improving symptoms of nOH, daily activities, falls, and standing systolic blood pressure in several recent trials. These trials demonstrated short-term efficacy and tolerability, with comparable increases in standing and supine blood pressures. Longer-term studies are ongoing to confirm durability of treatment effect.

Indexed as

PostureAccidental FallsAntiparkinson AgentsBlood PressureDroxidopaHumansHypotension, OrthostaticParkinson DiseaseTime FactorsTreatment OutcomeAntiparkinson AgentsDroxidopaautonomicfallslightheadednessnorepinephrine(pre)syncopetreatment

Identifiers

PMID24729712
PMCPMC3979788
OpenAlexW2009847776

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.