Treatment of High Altitude Polycythemia by Acetazolamide

2014-08-26 22:40:34 | BioPortfolio

Summary

The prevalence of High Altitude Polycythemia (or Chronic Mountain Sickness) is between 8 and 15% in the high altitude regions of South America. There is no pharmacological treatment available. After a first preliminary study in 2003 demonstrating the beneficial effects of acetazolamide in reducing hematocrit in these patients, after 3 weeks of treatment, we want to confirm this effect and implement a treatment protocol of 3 month-duration.

Description

Chronic mountain sickness (CMS) is characterized by an excessive number of red cells in the blood of persons living permanently above the altitude of 2,500m. The symptoms of this very incapacitating disease are : headaches, chronic asthenia, digestive troubles, sleep disturbances. The hemoglobin concentration is higher than 21 g/dl of blood. In addition, patients show a pulmonary hypertension of variable degree, as well as a systemic hypertension.

This disease affects essentially males, but women are also concerned after menopause. The evolution of the disease is always very dramatic, towards a cardiac failure and cerebral vascular stroke. The prevalence is between 8% and 15% on the Andean Altiplano . No pharmacological treatment is available.

A preliminary study was performed (Richalet et al. AJRCCM, 2005) that demonstrated the efficiency of acetazolamide (a carbonic anhydrase inhibitor) in reducing the hematocrit and the erythropoetin concentration,and increasing nocturnal oxygen saturation in patients suffering from CMS, after 3 weeks of treatment.

We plan to perform a double-blinded placebo-controlled study to evaluate the efficiency of a 3-month treatment with daily 250 mg acetazolamide to reduce the hematocrit and hemoglobin concentrations and ameliorate the clinical symptoms of 55 patients suffering from CMS and living at high altitude (Cerro de Pasco, Peru).

Study Design

Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment

Conditions

High Altitude Polycythemia

Intervention

acetazolamide

Location

University Cayetano Heredia
Lima
Peru
100

Status

Not yet recruiting

Source

Association pour la Recherche en Physiologie de l'Environnement

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-26T22:40:34-0400

Clinical Trials [72 Associated Clinical Trials listed on BioPortfolio]

Tadalafil and Acetazolamide Versus Acetazolamide in Acute Mountain Sickness Prevention

To evaluate the additive value of tadalafil given together with Diamox (acetazolamide) in preventing acute mountain sickness in travelers to high altitude areas.

Treatment of Patients With the Obstructive Sleep Apnea Syndrome at Altitude

The purpose of the study is to investigate the effect of acetazolamide as a treatment for sleep related breathing disturbances in patients with the obstructive sleep apnea syndrome living ...

Continuous Positive Airway Pressure and Acetazolamide to Treat Sleep Apnea Syndrome Patients at Altitude

The purpose of the study is to investigate the effect of nasal continuous positive airway pressure in combination with acetazolamide as a treatment for sleep related breathing disturbances...

Ghrelin, Growth Hormone and Growth Factors at High Altitude

Regulation of ghrelin, growth hormone and growth factors at high altitude and their change during ascent to high altitude has not been studied in depth yet. The study includes 33 volunteer...

Randomized, Controlled Trial of Regular Sildenafil Citrate in the Prevention of Altitude Illness

The purpose of this study is to determine whether regular oral use of sildenafil citrate can prevent or attenuate high altitude illnesses.

PubMed Articles [12794 Associated PubMed Articles listed on BioPortfolio]

Acetazolamide pre-treatment before ascending to high altitudes: when to start?

Hypoxia is the main responsible factor initiating the symptoms of acute mountain sickness (AMS) in susceptible individuals. Measures that improve oxygenation and/or hasten acclimatization like pre-tre...

Perinatal hypoxia increases susceptibility to high-altitude polycythemia and attendant pulmonary vascular dysfunction.

Perinatal exposures exert a profound influence on physiological function, including developmental processes vital for efficient pulmonary gas transfer, throughout the lifespan. We extend the concept o...

The Use of Dexamethasone in Support of High-Altitude Ground Operations and Physical Performance: Review of the Literature.

Objective: Military Special Operators (SOs) are exposed environmental conditions that can alter judgment and physical performance: uneven terrain, dryness of ambient air, reduction of air density, and...

Cardiorespiratory Fitness of High Altitude Mountaineers: The Underestimated Prerequisite.

Reversible Increase of Central Choroidal Thickness During High-Altitude Exposure.

This study aimed to quantify the impact of high altitude on choroidal thickness and relate changes of altered choroidal blood flow to clinical parameters and acute mountain sickness (AMS). This work i...

Medical and Biotech [MESH] Definitions

A morbid condition of ANOXIA caused by the reduced available oxygen at high altitudes.

The volume of packed RED BLOOD CELLS in a blood specimen. The volume is measured by centrifugation in a tube with graduated markings, or with automated blood cell counters. It is an indicator of erythrocyte status in disease. For example, ANEMIA shows a low value; POLYCYTHEMIA, a high value.

A vertical distance measured from a known level on the surface of a planet or other celestial body.

An increase in the total red cell mass of the blood. (Dorland, 27th ed)

Liquid chromatographic techniques which feature high inlet pressures, high sensitivity, and high speed.

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