Midodrine for the prevention of vasovagal syncope - A Randomized Clinical Trial
This RCT (n=133) found fewer patients receiving midodrine had at least 1 syncope episode vs placebo (42% vs 61%) [RR 0.69 (95% CI, 0.49 to 0.97; P=0.035)] and the number needed to treat to prevent 1 patient from having syncope was 5.3 (CI, 2.8 to 47.6).
Source:
Annals of Internal Medicine
SPS commentary:
Editorial discusses the findings of the RCT compared to data found from a systematic review and RCT which studied the syncope recurrence risk with midodrine. It highlights that several therapies, such as fludrocortisone, have shown effectiveness in previous RCTs therefore identifying most suitable therapy for patients requires individual assessment.