{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:42:17Z","timestamp":1790419337708,"version":"4.1.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T00:00:00Z","timestamp":1530662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Lundbeck LLC"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:p>Background: The comparative effects of droxidopa and midodrine on standing systolic blood pressure (sSBP) and risk of supine hypertension in patients with neurogenic orthostatic hypotension (NOH) are unknown. Objective: To perform a Bayesian mixed-treatment comparison meta-analysis of droxidopa and midodrine in the treatment of NOH. Methods: The PubMed, CENTRAL, and EMBASE databases were searched up to November 16, 2016. Study selection consisted of randomized trials comparing droxidopa or midodrine with placebo and reporting on changes in sSBP and supine hypertension events. Data were pooled to perform a comparison among interventions in a Bayesian fixed-effects model using vague priors and Markov chain Monte Carlo simulation with Gibbs sampling, calculating pooled mean changes in sSBP and risk ratios (RRs) for supine hypertension with associated 95% credible intervals (CrIs). Results: Six studies (4 administering droxidopa and 2 administering midodrine) enrolling a total of 783 patients were included for analysis. The mean change from baseline in sSBP was significantly greater for both drugs when compared with placebo (droxidopa 6.2 mm Hg [95% CrI = 2.4-10] and midodrine 17 mm Hg [95% CrI = 11.4-23]). Comparative analysis revealed a significant credible difference between droxidopa and midodrine. The RR for supine hypertension was significantly greater for midodrine, but not droxidopa, when compared with placebo (droxidopa RR = 1.4 [95% CrI = 0.7-2.7] and midodrine RR = 5.1 [95% CrI = 1.6-24]). Conclusion and Relevance: In patients with NOH, both droxidopa and midodrine significantly increase sSBP, the latter to a greater extent. However, midodrine, but not droxidopa, significantly increases risk of supine hypertension.<\/jats:p>","DOI":"10.1177\/1060028018786954","type":"journal-article","created":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T05:56:28Z","timestamp":1530683788000},"page":"1182-1194","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Standing and Supine Blood Pressure Outcomes Associated With Droxidopa and Midodrine in Patients With Neurogenic Orthostatic Hypotension: A Bayesian Meta-analysis and Mixed Treatment Comparison of Randomized Trials"],"prefix":"10.1177","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9671-9137","authenticated-orcid":false,"given":"Jack J.","family":"Chen","sequence":"first","affiliation":[{"name":"Marshall B. Ketchum University, Fullerton, CA, USA"},{"name":"Loma Linda University, CA, USA"},{"name":"American University of Health Sciences, Signal Hill, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Han","sequence":"additional","affiliation":[{"name":"WPP Health and Wellness, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Tang","sequence":"additional","affiliation":[{"name":"Cello Health, Yardley, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Portillo","sequence":"additional","affiliation":[{"name":"Chapman University, Orange, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Hauser","sequence":"additional","affiliation":[{"name":"University of South Florida, Tampa, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khashayar","family":"Dashtipour","sequence":"additional","affiliation":[{"name":"Loma Linda University, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,7,4]]},"reference":[{"key":"bibr1-1060028018786954","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-011-0119-5"},{"key":"bibr2-1060028018786954","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afw227"},{"key":"bibr3-1060028018786954","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000002086"},{"issue":"13","key":"bibr4-1060028018786954","first-page":"s248","volume":"21","author":"Low PA.","year":"2015","journal-title":"Am J Manag Care"},{"key":"bibr5-1060028018786954","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp074189"},{"key":"bibr6-1060028018786954","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6736-7"},{"key":"bibr7-1060028018786954","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-016-0410-9"},{"key":"bibr8-1060028018786954","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(16)30079-5"},{"key":"bibr9-1060028018786954","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-017-0453-9"},{"key":"bibr10-1060028018786954","unstructured":"Northera [package insert]. Charlotte, NC: Chelsea Therapeutics, Inc; 2014."},{"key":"bibr11-1060028018786954","unstructured":"Midodrine hydrochloride tablets [package insert]. 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Guidance for industry: enrichment strategies for clinical trials to support approval of human drugs and biological products. https:\/\/www.fda.gov\/downloads\/Drugs\/GuidanceComplianceRegulatoryInformation\/Guidances\/UCM332181.pdf. 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