Vasavada Advait M, Verma Deepak, Sheggari Vineetha, Ghetiya Srushti, Chirumamilla Punith Chowdary, Kotak Radhika A, Mahapatra Shruti Sagar, Patel Tirath, Jain Manisha
Internal Medicine, MP Shah Medical College, Jamnagar, IND.
Internal Medicine, Sri Guru Ram Das Institute Of Medical Sciences and Research, Amritsar, IND.
Cureus. 2023 May 11;15(5):e38887. doi: 10.7759/cureus.38887. eCollection 2023 May.
The literature on pharmacologic treatments for postural orthostatic tachycardia syndrome (POTS) is inconsistent and unstandardized. Therefore, we aimed to evaluate choices in pharmacologic treatment options for POTS and the challenges encountered in the studies. We searched numerous databases like PubMed, Scopus, Embase, Web of Science, and Google Scholar for literature published before April 8, 2023. The search was done to retrieve potential peer-reviewed articles that explored drug therapy in POTS. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used to conduct the systematic review. Of the 421 potential articles assessed, 17 met the inclusion criteria. Results demonstrated that pharmacologic treatment options for POTS were effective in reducing symptoms of POTS, but most of the studies were underpowered. Several were terminated due to various reasons. Midodrine ivabradine, bisoprolol, fludrocortisone, droxidopa, desmopressin, propranolol, modafinil, methylphenidate, and melatonin have been studied with positive impact but sample sizes that were low in the range of 10-50 subjects. Therefore, we concluded the treatment options effectively improve symptoms of POTS and increase orthostatic tolerance, but more evidence is needed as most studies had a low sample size and thus are underpowered.
关于体位性直立性心动过速综合征（POTS）药物治疗的文献并不一致且未标准化。因此，我们旨在评估POTS药物治疗方案的选择以及研究中遇到的挑战。我们在多个数据库中进行了检索，如PubMed、Scopus、Embase、科学网和谷歌学术，以查找2023年4月8日前发表的文献。此次检索旨在获取探讨POTS药物治疗的潜在同行评议文章。我们使用系统评价和Meta分析的首选报告项目（PRISMA）指南进行系统评价。在评估的421篇潜在文章中，17篇符合纳入标准。结果表明，POTS的药物治疗方案在减轻POTS症状方面有效，但大多数研究的样本量不足。有几项研究因各种原因终止。米多君、伊伐布雷定、比索洛尔、氟氢可的松、屈昔多巴、去氨加压素、普萘洛尔、莫达非尼、哌甲酯和褪黑素已被研究，且有积极影响，但样本量在10至50名受试者范围内较低。因此，我们得出结论，这些治疗方案有效改善了POTS症状并提高了直立耐受性，但由于大多数研究样本量较小，因此效力不足，还需要更多证据。
