Drug treatment for orthostatic hypotension

This will likely be of interest to the MSA folks or those with orthostatic hypotension as a symptom….

Beth Klitch has MSA. She lives in the Midwest. She posted this recently on an MSA digest; it’s about the success seen by Japanese researchers using an FDA-approved diabetes drug to treat post-prandial hypotension. I asked her permission to copy the post here because I think it may be useful to some of our group members.

To find the three-sentence Neurology journal article abstract the post below refers to, go to www.neurology.org and search for “voglibose.”


From: Beth Klitch
Date: Tue May 30, 2006 5:44pm(PDT)
Subject: Exciting new use of an existing drug to treat hypotension after meal

Since many of us with MSA suffer from severe orthostatic hypotension, me included, I keep a close eye on research reports about medications and other treatments that may be available to help us treat this condition. Just a few days ago, an interesting report surfaced in Neurology 2006;66:1432-1434 about a drug primarily used to treat diabetes, but which has profound implications to help treat the hypotension that occurs right after eating a meal, also called post-prandial hypotension. Note that MSA patients were included in this research along with Parkinson’s patients and patients with diabetes.

I have shared the article summary below for those who are interested. I think this is potentially great news for us because it is another example of an existing drug that can be extended to treat an additional condition and has already met the FDA’s safety and efficacy standards. The drug is called Voglibose, is marketed as Volix, and is considered one of the most important alpha-glucosidase inhibitors. It works in treating diabetes by delaying the digestion and absorption of carbohydrates, thereby decreasing the rise in glucose levels and insulin levels that typically occur after eating a meal.


NEW YORK (Reuters Health) May 24 – The alpha-glucosidase inhibitor voglibose can help reduce postprandial hypotension, Japanese researchers report in the May 9th issue of Neurology. Lead investigator Dr. Takahiro Maruta of Kanazawa University and colleagues note that reduced blood pressure after a meal is common in the elderly and in those with conditions such as Parkinson’s disease and diabetes mellitus. It can increase the risk of falls and coronary events.

To examine the effect of voglibose on postprandial hypotension, the researchers studied 48 elderly subjects including those with Parkinson’s disease, multiple system atrophy and diabetes as well as elderly and younger controls with no autonomic disorder. Within 2 hours of 75-g glucose loading, blood pressure fell by more than 20 mm Hg in 72.7% of the Parkinson’s patients, all of those with multiple system atrophy, 27.3% of the patients with diabetes, 23% of the elderly controls and none of the younger controls.

Following voglibose administration, there was a significant reduction in this drop in blood pressure. Without voglibose the mean drop was 41.5 mm Hg; with voglibose, it was 21.0 mm Hg. There was also a reduction in the duration of postprandial hypotension under the two conditions (52.3 minutes versus 17.3 minutes).

Summing up Dr. Maruta told Reuters Health, “Many people suffer from symptoms due to hypotension. Our research should cast some light on ways to help them.”