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Long-term noninvasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea

Mª Ángeles Sanchez Quiroga, Juan Fernando Masa Jiménez, Ivan Benitez, Javier Gómez De Terreros, Jaime Corral, Auxiliadora Romero, Candela Caballero Eraso, Maria Luz Alonso Alvarez, Estrella Ordax, Teresa Gomez Garcia, Soledad Lopez Martin, Jose Maria Marin, Sergi Marti, Trinidad Diaz Cambriles, Eusebi Chiner, Carlos Egea, Javier Barca, Francisco Javier Vazquez Polo, Miguel Angel Negrin, Maria Martel Escobar, Ferran Barbe, Babak Mohklesi
European Respiratory Journal 2020 56: 4349; DOI: 10.1183/13993003.congress-2020.4349
Mª Ángeles Sanchez Quiroga
1Vigen del Puerto Hospital, Plasencia, Spain
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  • For correspondence: mariansanqui@gmail.com
Juan Fernando Masa Jiménez
2San Pedro Alcántara Hospital, Cáceres, Spain
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Ivan Benitez
3Respiratory Diseases CIBER, Madrid, Spain
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Javier Gómez De Terreros
2San Pedro Alcántara Hospital, Cáceres, Spain
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Jaime Corral
2San Pedro Alcántara Hospital, Cáceres, Spain
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Auxiliadora Romero
4Virgen del Rocío University Hospital, Sevilla, Spain
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Candela Caballero Eraso
4Virgen del Rocío University Hospital, Sevilla, Spain
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Maria Luz Alonso Alvarez
5Burgos University Hospital, Burgos, Spain
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Estrella Ordax
5Burgos University Hospital, Burgos, Spain
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Teresa Gomez Garcia
6Fundación Jimenez Diaz Hospital, Madrid, Spain
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Soledad Lopez Martin
7Gregorio Marañón Hospital, Madrid, Spain
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Jose Maria Marin
8Miguel Servet Hospital, Zaragoza, Spain
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Sergi Marti
9Valld´Hebron Hospital, Barcelona, Spain
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Trinidad Diaz Cambriles
1012 de Octubre Hosital, Madrid, Spain
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Eusebi Chiner
11San Juan Hospital, Alicante, Spain
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Carlos Egea
12Alava University Hospital, Vitoria, Spain
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Javier Barca
13Extremadura University, Cáceres, Spain
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Francisco Javier Vazquez Polo
14University of Las Palmas de Gran Canarias, Las Palmas, Spain
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Miguel Angel Negrin
14University of Las Palmas de Gran Canarias, Las Palmas, Spain
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Maria Martel Escobar
14University of Las Palmas de Gran Canarias, Las Palmas, Spain
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Ferran Barbe
15Instituto de Investigación Biomédica de Lérida, Lérida, Spain
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Babak Mohklesi
16University of Chicago, Chicago, United States of America
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Abstract

Rationale: Noninvasive ventilation (NIV) is an effective treatment in obesity hypoventilation syndrome (OHS) with severe obstructive sleep apnoea (OSA) but there is paucity of evidence in OHS patients without severe OSA phenotype.

Methods: In this multicentre (16 sites in Spain), open-label parallel group clinical trial, we randomly assigned 98 stable ambulatory patients with untreated OHS and apnoea-hypopnoea index <30 events/hour to NIV or lifestyle modification (control). The primary end point was hospitalization days/year. The analysis was performed according to the intention-to-treat and per-protocol principles.

Results: 49 patients were randomised in each group and 48 patients were analysed in each one of them. During a median [IQR] follow-up of 4.98 [2.98; 6.62] years, mean (SD) hospitalization days/year was 2.60 (5.31) in the control group and 2.71 (4.52) in the NIV group [adjusted rate ratio (95% CI) 1.07 (0.44; 2.59) (p = 0.882)]. Cardiovascular events occurred in 11 (23%) participants in the control group and 10 (21%) in the NIV group (hazard ratio (95% CI) 0.96 (0.40;2.30), p=0.927). Similar results were observed in the per-protocol analysis [rate ratio (95% CI) 1.21 (0.43;3.41) (p=0.717)]. Death occurred in 9 (19%) participants in both arms (adjusted hazard ratio (95% CI) 1.07 (0.41;2.82), p=0.893). Similar results were found in the per-protocol analysis [rate ratio (95% CI) 1.38 (0.50;3.79) (p=0.529)].

Conclusion: In stable ambulatory patients with OHS without severe OSA, NIV and lifestyle modification had similar long-term hospitalization days-year. Larger studies are necessary to better determine the long-term benefit of NIV in this subgroup of OHS.

  • Apnoea / Hypopnea
  • Adults
  • RCT (Randomized Controlled Trial)

Footnotes

Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4349.

This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.

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 2020
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Long-term noninvasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea
Mª Ángeles Sanchez Quiroga, Juan Fernando Masa Jiménez, Ivan Benitez, Javier Gómez De Terreros, Jaime Corral, Auxiliadora Romero, Candela Caballero Eraso, Maria Luz Alonso Alvarez, Estrella Ordax, Teresa Gomez Garcia, Soledad Lopez Martin, Jose Maria Marin, Sergi Marti, Trinidad Diaz Cambriles, Eusebi Chiner, Carlos Egea, Javier Barca, Francisco Javier Vazquez Polo, Miguel Angel Negrin, Maria Martel Escobar, Ferran Barbe, Babak Mohklesi
European Respiratory Journal Sep 2020, 56 (suppl 64) 4349; DOI: 10.1183/13993003.congress-2020.4349

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Long-term noninvasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea
Mª Ángeles Sanchez Quiroga, Juan Fernando Masa Jiménez, Ivan Benitez, Javier Gómez De Terreros, Jaime Corral, Auxiliadora Romero, Candela Caballero Eraso, Maria Luz Alonso Alvarez, Estrella Ordax, Teresa Gomez Garcia, Soledad Lopez Martin, Jose Maria Marin, Sergi Marti, Trinidad Diaz Cambriles, Eusebi Chiner, Carlos Egea, Javier Barca, Francisco Javier Vazquez Polo, Miguel Angel Negrin, Maria Martel Escobar, Ferran Barbe, Babak Mohklesi
European Respiratory Journal Sep 2020, 56 (suppl 64) 4349; DOI: 10.1183/13993003.congress-2020.4349
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