PT  - JOURNAL ARTICLE
AU  - Michael Furian
AU  - Aline Buergin
AU  - Philipp M. Scheiwiller
AU  - Laura Mayer
AU  - Simon Schneider
AU  - Maamed Mademilov
AU  - Berik Emilov
AU  - Mona Lichtblau
AU  - Lara Muralt
AU  - Ulan Sheraliev
AU  - Nuriddin H. Marazhapov
AU  - Talant M. Sooronbaev
AU  - Silvia Ulrich
AU  - Konrad Ernst Bloch
TI  - Prevention of altitude-related illness in patients with COPD by acetazolamide. RCT
AID  - 10.1183/13993003.congress-2019.PA3938
DP  - 2019 Sep 28
TA  - European Respiratory Journal
PG  - PA3938
VI  - 54
IP  - suppl 63
4099  - http://erj.ersjournals.com/content/54/suppl_63/PA3938.short
4100  - http://erj.ersjournals.com/content/54/suppl_63/PA3938.full
SO  - Eur Respir J2019 Sep 28; 54
AB  - Introduction: The current randomized, placebo-controlled, double-blind trial evaluated whether acetazolamide (AZA) prevented altitude-related illness (ARI) in lowlanders with chronic obstructive pulmonary disease (COPD) ascending to high altitude.Methods: 176 COPD patients, FEV1 ≥40 to <80%predicted, living below 800m, were randomized to AZA (125-0-250mg/d) or placebo starting 24h before ascending to and while staying at 3100m for 48h. Primary outcome was the incidence of any of the following ARI at 3100m: acute mountain sickness (AMS, Lake Louise score >2 including headache), severe hypoxemia (SpO2 <80%, >30min) or any discomfort requiring medical intervention. Arterial blood gases and other outcomes were also assessed. www.ClinicalTrials.gov NCT03156231.Results: Of 90 patients (median age 58y, FEV1 64%predicted) randomized to placebo, 64 (71%) experienced ARI; of 86 patients (age 58y, FEV1 64%predicted) randomized to AZA, 35 (41%) experienced ARI, odds ratio 0.28, 95%CI 0.15 to 0.52, P<0.001. Compared to placebo, AZA reduced severe hypoxemia by 77% (incidence 48% vs. 12%, P<0.001) without changing AMS incidence (35% vs. 31%, P=0.579). At 3100m, day 2, AZA decreased PaCO2 by -0.3kPa (-0.5 to -0.1) and increased PaO2 by 0.8kPa (0.5 to 1.1) vs. placebo, P<0.001 both instances. No serious adverse events occurred.Conclusions: In lowlanders with moderate to severe COPD, staying for 48h at 3100m, ARI were common. AZA reduced the incidence of ARI by 42% through prevention of severe hypoxemia while the occurrence of AMS remained unchanged. The results suggest that lowlanders with COPD going to high altitude may benefit from preventive treatment with AZA.Grants: Swiss National Science Foundation, Lunge ZurichFootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA3938.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).