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Clinical Trials for Orthostatic Hypotension in Parkinson’s Disease and Other Synucleinopathies

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Clinical Trials In Parkinson's Disease

Part of the book series: Neuromethods ((NM,volume 160))

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Abstract

Neurogenic orthostatic hypotension (nOH) is one of the most debilitating nonmotor symptoms in patients with Parkinson disease and other synucleinopathies. Patients with Parkinson disease and nOH suffer from more hospitalizations, emergency room visits, more telephone calls and e-mails to providers, and have a significantly shorter survival compared to patients with Parkinson disease and no nOH. Overall, health-related costs in patients with Parkinson disease and OH are 2.5-fold higher compared to patients with Parkinson disease without OH. Therefore, the development of effective therapies for patients with Parkinson disease and nOH should be a research priority. In recent years, better understanding of the pathophysiology of nOH has resulted in the identification of novel therapeutic targets and the development and approval of effective drug therapies, such as midodrine and droxidopa. We here review the design and endpoint selection for clinical trials of nOH in patients with Parkinson disease and other synucleinopathies, recapitulate the results of completed and ongoing clinical trials for nOH, and discuss common challenges and their potential remedies.

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  1. Department of Neurology, Dysautonomia Center, New York University School of Medicine, New York, NY, USA

    Jose-Alberto Palma & Horacio Kaufmann

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  1. National Research Council (CAECHIS-UAI), Buenos Aires, Argentina

    Santiago Perez-Lloret

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Palma, JA., Kaufmann, H. (2021). Clinical Trials for Orthostatic Hypotension in Parkinson’s Disease and Other Synucleinopathies. In: Perez-Lloret, S. (eds) Clinical Trials In Parkinson's Disease. Neuromethods, vol 160. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-0912-5_13

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