Is cinnarizine/betahistine combination superior to respective monotherapies in treatment of vertigo? Comment on a randomized triple-blind placebo-controlled trial
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We read with great interest the report of a randomized, triple-blind, placebo-controlled trial (RCT) conducted by Asadi et al. , to compare efficacy of cinnarizine and betahistine combination with their monotherapies in patients with acute peripheral vertigo (APV). Despite abundant use of betahistine for vertigo, a Cochrane systematic review concluded that available supporting evidence had low quality [2, 3]. The study by Asadi et al. could provide valuable evidence if its robustness was assured. The authors concluded that cinnarizine and betahistine monotherapies were effective but the combination was superior; however, the conclusion would be questionable considering following points.
First question emerged regarding the study inclusion and exclusion criteria. We faced ambiguity in the term “APV.” Whether it meant patients with acute vestibular vertigo or peripheral vertigo with unknown origin was unclear. It was not clear either, whether severity of the symptoms, history of...
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