SynthesisClinical autonomic research : official journal of the Clinical Autonomic Research Society2016
Meta-analysis of the safety and efficacy of droxidopa for neurogenic orthostatic hypotension.
Synthesis in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 52 citations in OpenAlex.
- The Vagal Link: Autonomic Nervous System Dysfunction in Cardiac Amyloidosis.Journal of clinical medicine · 2025Review
- Mechanism-based therapy of non-cardiac syncope: a practical guide.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Recent Advances and Future Directions in Syncope Management: A Comprehensive Narrative Review.Journal of clinical medicine · 2024Review
- Supportive Care and Symptom Management for Patients With Immunoglobulin Light Chain (AL) Amyloidosis.Frontiers in oncology · 2022Review
- Current Management and Emerging Therapies in Multiple System Atrophy.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2020Review
- Clinical Trials for Neurogenic Orthostatic Hypotension: A Comprehensive Review of Endpoints, Pitfalls, and Challenges.Seminars in neurology · 2020Review
- Orthostatic Hypotension in Parkinson Disease.Clinics in geriatric medicine · 2020Review
- Management of Orthostatic Hypotension.Continuum (Minneapolis, Minn.) · 2020Review
- Orthostatic hypotension in hereditary transthyretin amyloidosis: epidemiology, diagnosis and management.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2019Review
- Orthostatic hypotension: From pathophysiology to clinical applications and therapeutic considerations.Journal of clinical hypertension (Greenwich, Conn.) · 2019Review
- Role of nurses and nurse practitioners in the recognition, diagnosis, and management of neurogenic orthostatic hypotension: a narrative review.International journal of general medicine · 2019Review
- Supine plasma NE predicts the pressor response to droxidopa in neurogenic orthostatic hypotension.Neurology · 2018Observational
- Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies.Movement disorders : official journal of the Movement Disorder Society · 2018Review
- Review
- Droxidopa for symptomatic neurogenic orthostatic hypotension: what can we learn?Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2017Article
- Defining successful treatment of neurogenic orthostatic hypotension with droxidopa in a patient with multiple system atrophy.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2017Article
- Initiating droxidopa for neurogenic orthostatic hypotension in a patient with Parkinson disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2017Article
- Managing neurogenic orthostatic hypotension with droxidopa in a patient with Parkinson disease, atrial fibrillation, and hypertension.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2017Article
- Adding droxidopa to fludrocortisone or midodrine in a patient with neurogenic orthostatic hypotension and Parkinson disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2017Article
- Differential diagnosis of suspected neurogenic orthostatic hypotension in a patient with Parkinson disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2017Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDroxidopa has been approved for the treatment of neurogenic orthostatic hypotension (NOH) under the US Food and Drug Administration accelerated approval program, which warrants confirmatory evidence on long-term efficacy of droxidopa. Hereby, we synthesize evidence from published randomized controlled trials (RCTs) about the safety and efficacy of droxidopa for patients with neurogenic orthostatic hypotension.
methodsA computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central was conducted using relevant keywords. Records were screened for eligible studies and data were extracted and synthesized using Review Manager version 5.3 for Windows. Subgroup analysis and sensitivity analysis were conducted to investigate long-term durability of droxidopa against placebo.
resultsFour RCTs with a total of 485 patients (droxidopa, n = 246; placebo, n = 239) were eligible for the final analysis. The mean difference (MD) of change in the main outcomes from baseline to endpoint favored droxidopa than placebo [Orthostatic Hypotension Questionnaire (OHQ) MD -0.61, P = 0.004; dizziness/lightheadedness score MD -0.83, P = 0.008; and standing systolic blood pressure (SBP) MD 4.09, P = 0.03]. The efficacy of droxidopa decreased gradually after 2 weeks, and its statistical significance was lost after 8 weeks (OHQ score MD -0.18, P = 0.61; dizziness/lightheadedness score MD -0.71, P = 0.11; and standing SBP MD 2.96, P = 0.29). None of the adverse events were significantly higher in the case of droxidopa compared to placebo.
conclusionDroxidopa is a safe and effective drug for the short-term management of NOH symptoms. However, current evidence is insufficient to confirm the efficacy of droxidopa for long-term use. Therefore, further studies with increased sample size are needed.
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What OpenQuestion holds
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.