Midodrine Cuts Recurrent Syncope in Young, Healthy Patients
Absolute risk reduced by 19 percentage points, with number needed to treat to prevent syncope of 5.3
TUESDAY, Aug. 3, 2021 (HealthDay News) -- For patients with recurrent vasovagal syncope and no serious comorbid conditions, midodrine can reduce the recurrence of syncope, according to a study published online Aug. 3 in the Annals of Internal Medicine.
Robert Sheldon, M.D., Ph.D., from the University of Calgary in Alberta, Canada, and colleagues examined whether midodrine can prevent vasovagal syncope in a randomized trial involving patients with recurrent vasovagal syncope and no serious comorbid conditions. A total of 133 patients (median age, 32 years; 73 percent female) with a median of six syncope episodes in the previous year were randomly assigned to either placebo or midodrine in a 1:1 ratio.
The researchers found that fewer patients receiving midodrine had at least one syncope episode compared with those receiving placebo (42 versus 61 percent; relative risk, 0.69). The absolute risk reduction was 19 percent and number needed to treat was 5.3. Patients receiving midodrine had a longer time to first syncope (hazard ratio, 0.59). Both groups had similar adverse effects.
"Midodrine is effective in reducing the likelihood of a syncope recurrence in younger patients with frequent syncope when it is administered in conjunction with guideline-directed teaching about lifestyle risk reduction," the authors write.