RT Journal Article
SR Electronic
T1 The Pickwick randomized clinical trial: long-term positive airway pressure therapy in obesity hypoventilation syndrome
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2015
DO 10.1183/13993003.congress-2019.PA2015
VO 54
IS suppl 63
A1 Mª Ángeles Sanchez Quiroga
A1 Juan Fernando Masa Jiménez
A1 Babak Mokhlesi
A1 Ivan Benítez
A1 Francisco Javier Gómez De Terreros
A1 Auxiliadora Romero
A1 Candela Caballero Eraso
A1 Joaquin Teran Santos
A1 María Luz Alonso Álvarez
A1 María Fernanda Troncoso
A1 Mónica González
A1 Soledad López Martin
A1 José María Marín
A1 Sergi Marti
A1 Trinidad Díaz Cambriles
A1 Eusebi Chiner
A1 Carlos Egea Santaolalla
A1 Javier Barca
A1 Francisco Jesus Vázquez Polo
A1 Miguel Angel Negrin
A1 Maria Martel Escobar
A1 Ferran Barbe
A1 Jaime Corral
YR 2019
UL http://erj.ersjournals.com/content/54/suppl_63/PA2015.abstract
AB Rationale: Obesity hypoventilation syndrome (OHS) is commonly treated with CPAP or noninvasive ventilation (NIV). NIV is more complex and costly but it provides ventilatory support. To date there have been no long-term trials comparing these treatment modalities.Methods: We performed a large, multicenter, open-label controlled trial in Spain to compare the long-term effectiveness of NIV and CPAP: respiratory function, Epworth sleepness scale (ESS), other clinical symptoms, blood pressure (BP) and health related quality of life (HRQL). The analysis was performed according to the intention-to-treat principle.Results: In total, 215 patients with untreated OHS and severe obstructive sleep apnea (OSH) were randomized to NIV or CPAP therapy and followed at least 3 years. PaCO2, bicarbonate and pH improved significantly with both treatments without group differences. FEV1 and FVC improved with positive airway pressure (PAP) but without significant group differences. The 6-MWD test did not improve with either PAP modality and there were no significant group differences. ESS and other clinical symptoms like dyspnea or unrefreshing sleep improved similarly with CPAP and NIV therapy. Both systolic and diastolic BP improved significantly with PAP but without group differences. HRQL tests (SF-36 physical and mental, FOSQ and VAWS) improved with PAP without any significant group differences.Conclusions: In stable patients with OHS and severe OSA, NIV and CPAP have similar long-term effectiveness improving respiratory function, symptoms, BP and HRQL. Given that CPAP has lower complexity and cost, CPAP may be the preferred treatment modality until more studies become available.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2015.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).