Clinical trial of mirabegron for POTS underway, 2025

[kushami]

“Using Mirabegron to Increase Blood Pressure in Patients with Postural Orthostatic Tachycardia Syndrome”

https://clinicaltrials.gov/study/NCT06133075

The trial is looking at a medication called mirabegron to see whether it could be a new treatment for POTS patients with low blood pressure who have been refractive to existing treatments. It is proposed that it:

increases systolic blood pressure (BP), prevents syncope/presyncope, and improves the quality of life (QOL), functional capacity, chest pain, and overactive bladder (OAB) symptoms in patients with postural orthostatic tachycardia syndrome (POTS) who have a documented history of hypotension inadequately responsive to conventional treatments.

The trial is funded by the American Heart Association.

 

[kushami]

Looking through reviews for this medication, I noticed a polarising effect. About half of the reviewers found it effective and experienced minimal side effects, and about half found it ineffective and experienced unpleasant side effects. There was not the usual spread from low through to high ratings.

So it seems it either works well, or makes you feel awful. Pity we can’t know beforehand which group people will fall into, especially as it will be expensive in some countries.

This fits with a comment in a POTS forum that it works very well for those who can tolerate it.

So I predict that in the study results we will see a high drop-out rate due to side effects, but favourable results with the people who could continue taking it. A sort of “all or nothing” effect. Interesting.