POST-4
Prevention of Syncope Trial 4
Patient / Population Intervention / Exposition Vergleich Endpunkt
In 133 patients with recurrent vasovagal syncope and no serious comorbidity, midodrine reduced the proportion of patients with at least one syncope episode over 12 months compared with placebo.
N
133
Design
Double-blind, placebo-controlled RCT
Endpunkt
Proportion with ≥1 syncope episode over 12 months
Relevanz
2
Ergebnis42 % vs 61 % (relative risk 0.69; 95 % CI 0.49–0.97; p=0.035); absolute reduction 19 percentage points; NNT 5.3. Adverse effects similar in both arms.
Sheldon R, Faris P, Tang A, et al. Ann Intern Med. 2021;174(10):1349-1356. 10.7326/M20-5415
Diskussion & Kritik
Small, short of its planned enrolment, followed for only 12 months and drawn largely from one centre, so the confidence interval brushes unity. Even so it is the only adequately powered placebo-controlled trial of midodrine and makes it the best-supported drug for young, healthy patients with a heavy syncope burden.