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Treatment of High Altitude Polycythemia by Acetazolamide

2014-08-27 03:40:34 | 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: 2014-08-27T03:40:34-0400

Clinical Trials [129 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.

Effect of Acetazolamide on Right Ventricular Function at Rest in Patients With Respiratory Disease at Altitude

This trial will evaluate the effect of acetazolamide (375 mg per day) vs. placebo on right ventricular function at acute altitude exposure in patients with COPD.

Effect of Acetazolamide on Postural Control in Patients With Respiratory Disease at Altitude

In this trial, the investigators will evaluate the effect of acetazolamide (375 mg per day) vs. placebo on postural control at acute altitude exposure in patients with COPD.

Altitude Sickness Prevention and Efficacy of Comparative Treatments

This study is designed to be the first to examine the novel drug budesonide for prevention of acute mountain sickness in comparison to acetazolamide and in the context of rapid ascent to h...

Effect of Acetazolamide on Exercise Performance in Patients With Respiratory Disease at Altitude

In this trial, the investigators will evaluate the effect of acetazolamide (375 mg per day) vs. placebo on exercise performance at altitude in patients with COPD.

PubMed Articles [11856 Associated PubMed Articles listed on BioPortfolio]

Natural Selection on Genes Related to Cardiovascular Health in High-Altitude Adapted Andeans.

The increase in red blood cell mass (polycythemia) due to the reduced oxygen availability (hypoxia) of residence at high altitude or other conditions is generally thought to be beneficial in terms of ...

Breathlessness at High Altitude: First Episode of Bronchoconstriction in an Otherwise Healthy Sojourner.

Bhandari, Sanjeeb Sudarshan, Pranawa Koirala, Sadichhya Lohani, Pratibha Phuyal, and Buddha Basnyat. Breathlessness at high altitude: first episode of bronchoconstriction in an otherwise healthy sojou...

Travelling safely to places at high altitude - Understanding and preventing altitude illness.

Greater numbers of people are travelling to places at high altitude each year. Altitude illness is common in places at high altitude and may be life-threatening. General practitioners (GPs) are best p...

Comparative transcriptomics of five high-altitude vertebrates and their low-altitude relatives.

Species living at high altitude are subject to strong selective pressures due to inhospitable environments (e.g., hypoxia, low temperature, high solar radiation, and lack of biological production), ma...

Advances in the Prevention and Treatment of High Altitude Illness.

High altitude illness encompasses a spectrum of clinical entities to include: acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. These illnesses occur as a resul...

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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