Atomoxetine for suppression of vasovagal syncope,Clinical Autonomic Research

当前位置： X-MOL 学术 › Clin. Auton. Res. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Atomoxetine for suppression of vasovagal syncope
Clinical Autonomic Research ( IF 3.9 ) Pub Date : 2022-11-19 , DOI: 10.1007/s10286-022-00905-x
Robert S Sheldon ₁ , Colette Seifer ₂ , Ratika Parkash ₃ , Roopinder K Sandhu ₄ , Rasha Hamzeh ₁ , Satish R Raj ₁

Affiliation

Objective

Vasovagal syncope (VVS) is a common clinical condition with few effective medical therapies. The study aimed to evaluate the effectiveness of atomoxetine in suppressing syncope in patients with recurrent VVS.

Methods

This was a retrospective, open-label, observational case series of 12 patients taking atomoxetine for suppression of recurrent vasovagal syncope. We compared syncope frequency in the 1 year before atomoxetine and while subjects were taking atomoxetine. We used novel applications of the Poisson distribution to describe the results as a collection of n = 1 studies.

Results

There were 12 subjects, eight female, with a mean age 47 ± 22 years and a mean Calgary Syncope Symptom Score of 2 (diagnostic of vasovagal syncope). The patients received a mean dose of atomoxetine of 66 ± 16 mg (1.06 ± 0.21 mg/kg). The mean follow-up period was 1.21 ± 1.01 years. While taking atomoxetine, 11/12 patients appeared to improve and 7/12 had no syncope in follow-up (p = 0.0046). The annualized syncope frequency decreased from a median 5.5 (IQR 4, 6.75) syncope per year to 0 (IQR 0, 0.88) syncope per year (p = 0.002, Wilcoxon rank-sum test). According to the Poisson distribution, 7/12 subjects significantly improved with p values of < 0.0001 to 0.0235, 3/12 did not faint but had too brief follow-up times to detect significance, and 2/12 did not improve significantly.

Conclusions

In this case series, atomoxetine was a promising oral agent for the prevention of vasovagal syncope. The Poisson distribution permits individual patient-level assessment of improvement and detects insufficient follow-up despite apparent improvement.

中文翻译：

阿托西汀抑制血管迷走性晕厥

客观的

血管迷走神经性晕厥 (VVS) 是一种常见的临床病症，几乎没有有效的药物治疗方法。该研究旨在评估托莫西汀抑制复发性 VVS 患者晕厥的有效性。

方法

这是一项回顾性、开放标签、观察性病例系列，共纳入 12 名服用托莫西汀抑制复发性血管迷走性晕厥的患者。我们比较了服用托莫西汀前 1 年和受试者服用托莫西汀时的晕厥频率。我们使用泊松分布的新颖应用将结果描述为n = 1 项研究的集合。

结果

共有 12 名受试者，8 名女性，平均年龄 47 ± 22 岁，平均卡尔加里晕厥症状评分为 2（诊断为血管迷走性晕厥）。患者接受的托莫西汀平均剂量为 66 ± 16 mg (1.06 ± 0.21 mg/kg)。平均随访时间为 1.21 ± 1.01 年。在服用托莫西汀期间，11/12 名患者出现好转，7/12 名患者在随访中没有出现晕厥 ( p = 0.0046)。年度晕厥频率从每年 5.5 (IQR 4, 6.75) 次晕厥的中位数下降到每年 0 (IQR 0, 0.88) 次晕厥（p = 0.002，Wilcoxon 秩和检验）。根据泊松分布，7/12 受试者显着改善p< 0.0001 到 0.0235 的值，3/12 没有晕倒，但随访时间太短无法检测到显着性，2/12 没有显着改善。