Abstract
Objective: Effects of acetazolamide (AZA) on exercise performance are debated. The current randomized, placebo-controlled, double-blind trial investigates effects of preventive treatment with AZA on exercise performance in patients with COPD ascending to high altitude.
Methods: COPD patients, FEV1≥40 to <80%predicted, living <800m, were randomized to AZA (125-0-250mg/day) or placebo, starting 24h before ascent to and while staying at 3100m for 48h. Patients performed progressive cycling exercise to exhaustion at 760m, before taking the study drug, and within 4h after arrival at 3100m. Primary outcome was maximal power output (Wmax). www.ClinicalTrials.gov NCT03177837.
Results: 103 patients were included in per protocol analysis. In 53 patients receiving AZA, Wmax and oxygen uptake (V’O2max) at 760m and 3100m were 105±40 and 91±40watts, and 18.0±6.8 and 15.5±6.8ml/min/kg (P<0.001, both instances). Corresponding Wmax and V’O2max in 50 patients receiving placebo were 107±41 and 97±41watts, and 18.9±7.0 and 17.2±7.0ml/min/kg (P<0.001, both instances). Between-group differences (95%CI) in altitude-induced changes (AZA vs. placebo) in Wmax were -3watts (-9 to 3, P=0.305) and in V’O2max -0.8ml/min/kg (-2.1 to 0.5, P=0.213). At end-exercise, AZA mitigated altitude-induced reductions of PaO2 by 0.7kPa (0.1 to 1.3), reduced pH by 0.04 (0.02 to 0.06) and serum lactic acid by 1.6mmol/l (0.8 to 2.4).
Conclusions: Lowlanders with moderate to severe COPD travelling to 3100m experienced a 10% reduction in maximal exercise performance. Preventive AZA treatment improved hypoxemia at 3100m but did not alter performance.
Grants: Swiss National Science Foundation, Lunge Zurich
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA1631.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019