TY - JOUR
T1 - The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension
AU - Gibbons, Christopher H.
AU - Schmidt, Peter
AU - Biaggioni, Italo
AU - Frazier-Mills, Camille
AU - Freeman, Roy
AU - Isaacson, Stuart
AU - Karabin, Beverly
AU - Kuritzky, Louis
AU - Lew, Mark
AU - Low, Phillip
AU - Mehdirad, Ali
AU - Raj, Satish R.
AU - Vernino, Steven
AU - Kaufmann, Horacio
N1 - Funding Information:
The authors were participants in a consensus panel meeting which took place in Boston, MA, USA, on November 7, 2015. This meeting was jointly held by the American Autonomic Society and the National Parkinson Foundation and funded by Lundbeck. All authors have contributed to the development and writing of the manuscript. In addition, medical writing and editorial assistance was provided by Keith C. Lantz, MS, CMPP (Link Health Group, LLC, Bridgewater, NJ) and funded by Lundbeck.
Funding Information:
Dr. Gibbons is on advisory boards for Pfizer and Lundbeck, is on data safety monitoring boards for Janssen and Astellas, and received research funding from Celgene and Grifols Inc. Dr. Schmidt has nothing to disclose. Dr. Biaggioni served as a clinical trial investigator for Lundbeck and is a consultant/advisor for Shire Pharmaceutical and Lundbeck. Dr. Frazier-Mills is on an advisory board for Lundbeck. Dr. Freeman is on an advisory board for Lundbeck. Dr. Isaacson has received honoraria for CME, is a consultant/advisor, received research funding/grants, and/or is a promotional speaker on behalf of AbbVie, Acadia Pharmaceuticals, Adamas Pharmaceuticals, Addex Therapeutics, Allergan, Allon Therapeutics, Amarantus Bioscience, AstraZeneca, Auspex Pharmaceuticals, Biotie Therapies, Britannia Pharmaceuticals, Chelsea Therapeutics, Civitas Therapeutics, Cynapsus Therapeutics, Eisai, GE Healthcare, GSK, Impax Pharmaceuticals, Ipsen, Kyowa, Lilly, Lundbeck, Merck, Schering-Plough, Medtronics, Merz, Michael J Fox Foundation, Novartis, Neurocrine Biosciences, NIH, Novartis, Orion, Parkinson Study Group, Pfizer, Phytopharm Plc, Purdue Pharma, Roche, Santhera Pharmaceuticals, Serono, Shire, Teva, UCB, US World Meds, Vanda Pharmaceuticals, and Xenoport. Dr. Karabin is a speaker and consultant for Lundbeck. Dr. Kuritzky is a speaker, consultant, and on an advisory board for Lundbeck. Dr. Lew is a consultant/advisor for Teva, US World Meds, UCB, Acadia, Auspex, Lundbeck, Abbvie, Impax, Cynapsus, Adamas, and Jazz; he is a speaker for Teva, USWM, UCB Pharma, Lundbeck, Acadia, and Impax; and he is a clinical researcher for Parkinson’s Study Group, Michael J. Fox Foundation, Civitas, Biotie, Intec Pharma, Neuroderm, the United States National Institutes of Health (NIH), and Enterin. Dr. Low has nothing to disclose. Dr. Mehdirad is a speaker for Lundbeck. Dr. Raj is on an advisory board for Lundbeck, is a consultant for GE Healthcare, is a clinical trial investigator for Medtronic and Bristol Myers Squibb, and received research funding from the Canadian Institutes of Health Research (CIHR). Dr. Vernino is on an advisory board and speaker bureau for Lundbeck and is a scientific consultant for Athena Diagnostics (a division of Quest). Dr. Kaufmann is on an advisory board for Lundbeck, ICE for Astra Zeneca, and has received research funding from the United States Food and Drug Administration (FDA) and NIH.
Publisher Copyright:
© 2016, The Author(s).
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson’s disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards ‘best practices’ when treating patients with nOH and associated supine hypertension. To address these issues, the American Autonomic Society and the National Parkinson Foundation initiated a project to develop a statement of recommendations beginning with a consensus panel meeting in Boston on November 7, 2015, with continued communications and contributions to the recommendations through October of 2016. This paper summarizes the panel members’ discussions held during the initial meeting along with continued deliberations among the panel members and provides essential recommendations based upon best available evidence as well as expert opinion for the (1) screening, (2) diagnosis, (3) treatment of nOH, and (4) diagnosis and treatment of associated supine hypertension.
AB - Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson’s disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards ‘best practices’ when treating patients with nOH and associated supine hypertension. To address these issues, the American Autonomic Society and the National Parkinson Foundation initiated a project to develop a statement of recommendations beginning with a consensus panel meeting in Boston on November 7, 2015, with continued communications and contributions to the recommendations through October of 2016. This paper summarizes the panel members’ discussions held during the initial meeting along with continued deliberations among the panel members and provides essential recommendations based upon best available evidence as well as expert opinion for the (1) screening, (2) diagnosis, (3) treatment of nOH, and (4) diagnosis and treatment of associated supine hypertension.
KW - Autonomic dysfunction
KW - Droxidopa
KW - Fludrocortisone
KW - Midodrine
KW - Neurogenic orthostatic hypotension
KW - Supine hypertension
UR - http://www.scopus.com/inward/record.url?scp=85008219651&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85008219651&partnerID=8YFLogxK
U2 - 10.1007/s00415-016-8375-x
DO - 10.1007/s00415-016-8375-x
M3 - Review article
C2 - 28050656
AN - SCOPUS:85008219651
SN - 0340-5354
VL - 264
SP - 1567
EP - 1582
JO - Deutsche Zeitschrift fur Nervenheilkunde
JF - Deutsche Zeitschrift fur Nervenheilkunde
IS - 8
ER -