自律神経疾患の治療の進歩

抄録

We reviewed articles on novel development of neurological treatment published in 2019. The combination of pyridostigmine and atomoxetine was reported to have a synergistic effect on improvement in neurogenic orthostatic hypotension. It was reported that lixisenatide and metformin have a potential to improve post prandial hypotension. Studies on pacemaker treatment for vasovagal syncope was systematically reviewed, and closed–loop stimulation evidenced a statistically meaningful reduction in syncopal burden. A meta–analysis showed that intradetrusor injection of botulinum toxin A was effective and safe for neurogenic detrusor overactivity. The different treatment methods in management of neurogenic bladder in patients with Parkinson's disease was systematically reviewed, but at present there is little or no evidence that treatment improves. Phase III randomized, double–blind, placebo–controlled study indicated that a linaclotide was effective and safe in Japanese patients with chronic constipation. Glycopyrronium tosylate applied topically was reported to improve primary axillary hyperhidrosis. Oral pilocarpine was reported to alleviate heat retention and cholinergic urticaria in patients with acquired idiopathic generalized anhidrosis.