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Phase 2 N=20 Randomized Treatment

Using Mirabegron to Increase BP in Patients With POTS

Postural Orthostatic Tachycardia Syndrome · Chronic Orthostatic Intolerance · Syncope

Enrolled (actual)
20
Serious AEs
0.0%
Results posted
Apr 2026
Primary outcome: Primary: Blood Pressure — 101; 107; 64; 68 mmHg

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Mirabegron 50 MG (Drug); Mirabegron 25 MG (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Cedars-Sinai Medical Center
Primary completion
May 2025

Outcome Measures

OutcomeResultp-value
PRIMARY
Blood Pressure
101; 107; 64; 68; 101; 108
SECONDARY
Syncope
0; 0; 0; 0
SECONDARY
Hypotensive Episode
1.5; 1.9; 1.8; 0.3
SECONDARY
Duke Activity Status Index Questionnaire
24; 12; 30; 9
SECONDARY
EQ-5D-5L Questionnaire
0.70; 0.18; 59; 34; 0.73; 0.27
SECONDARY
Seattle Angina Questionnaire (SAQ)
72; 37; 44; 38; 86; 69
SECONDARY
Overactive Bladder Symptoms
25; 50; 79; 55; 15; 18

Summary

This is a pilot dose-finding study to test the hypothesis that mirabegron 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 American Heart Association funds this study.

Eligibility Criteria

Inclusion Criteria

  • Provision of signed and dated informed consent form.
  • Age > 18 years old.
  • Documented history of chronic (> 3 months) of orthostatic intolerance.
  • Diagnosis of syncope or pre-syncope and documented intermittent hypotension unresponsive to conventional life-style modification therapy.
  • A history of syncope (complete loss of consciousness) or presyncope (the sensation that one is about to pass out).
  • At least one documented hypotensive episode with systolic BP 30 seconds) arrhythmias including paroxysmal supraventricular tachycardia, atrial flutter, ventricular tachycardia, ventricular fibrillation.
  • Symptomatic bradycardia before pacemaker implantation.
  • Heart failure with either preserved or reduced ejection fraction.
  • Wolff Parkinson-White Syndrome.
  • Stroke within the past 6 months.
  • Any history of myocardial infarction.
  • Active thyrotoxicosis.
  • Any experimental medication concomitantly or within 4 weeks of participation in the study.
  • Patients < 18 years old because mirabegron is not approved by FDA for use in children.
  • People with a history of allergy to ECG electrodes or adhesive tape.
  • Patients with known contraindications or precautions to mirabegron.
  • Hypertension
  • Severe renal impairment (calculated CrCl < 30ml/min)
  • Hepatic disease (Child-Pugh Class B)
  • Pregnant or lactation
  • Geriatric patients in long term care facilities
  • Patients who are known to be allergic to mirabegron
  • Patients taking drugs that are CYP2D6 substrates, such as midodrine. An extensive list can be found at the following website: https://drug-interactions.medicine.iu.edu/MainTable.aspx
  • Prisoners
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT06133075). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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