Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials
BACKGROUND: Acute mountain sickness (AMS) is a benign and self-limiting syndrome, but can progress to life-threatening conditions if leave untreated. This study aimed to assess the efficacy of acetazolamide for the prophylaxis of AMS, and disclose factors that affect the treatment effect of acetazol...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Annals of Thoracic Medicine |
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| Online Access: | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2021;volume=16;issue=4;spage=337;epage=346;aulast=Gao |
| _version_ | 1819038683026685952 |
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| author | Daiquan Gao Yuan Wang Rujiang Zhang Yunzhou Zhang |
| author_facet | Daiquan Gao Yuan Wang Rujiang Zhang Yunzhou Zhang |
| author_sort | Daiquan Gao |
| collection | DOAJ |
| description | BACKGROUND: Acute mountain sickness (AMS) is a benign and self-limiting syndrome, but can progress to life-threatening conditions if leave untreated. This study aimed to assess the efficacy of acetazolamide for the prophylaxis of AMS, and disclose factors that affect the treatment effect of acetazolamide.METHODS: Randomized controlled trials comparing the use of acetazolamide versus placebo for the prevention of AMS were included. The incidence of AMS was our primary endpoint. Meta-regression analysis was conducted to explore factors that associated with acetazolamide efficacy. Trial sequential analyses were conducted to estimate the statistical power of the available data.RESULTS: A total of 22 trials were included. Acetazolamide at 125, 250, and 375 mg/bid significantly reduced incidence of AMS compared to placebo. TAS indicated that the current evidence was adequate confirming the efficacy of acetazolamide at 125, 250, and 375 mg/bid in lowering incidence of AMS. There was no evidence of an association between efficacy and dose of acetazolamide, timing at start of acetazolamide treatment, mode of ascent, AMS assessment score, timing of AMS assessment, baseline altitude, and endpoint altitude.CONCLUSION: Acetazolamide is effective prophylaxis for the prevention of AMS at 125, 250, and 375 mg/bid. Future investigation should focus on personal characteristics, disclosing the correlation between acetazolamide efficacy and body mass, height, degree of prior acclimatization, individual inborn susceptibility, and history of AMS. |
| first_indexed | 2024-12-21T08:41:12Z |
| format | Article |
| id | doaj.art-b4d1ec8703a641b29bdec8b6c8676523 |
| institution | Directory Open Access Journal |
| issn | 1817-1737 1998-3557 |
| language | English |
| last_indexed | 2024-12-21T08:41:12Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Thoracic Medicine |
| spelling | doaj.art-b4d1ec8703a641b29bdec8b6c86765232022-12-21T19:09:57ZengWolters Kluwer Medknow PublicationsAnnals of Thoracic Medicine1817-17371998-35572021-01-0116433734610.4103/atm.atm_651_20Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trialsDaiquan GaoYuan WangRujiang ZhangYunzhou ZhangBACKGROUND: Acute mountain sickness (AMS) is a benign and self-limiting syndrome, but can progress to life-threatening conditions if leave untreated. This study aimed to assess the efficacy of acetazolamide for the prophylaxis of AMS, and disclose factors that affect the treatment effect of acetazolamide.METHODS: Randomized controlled trials comparing the use of acetazolamide versus placebo for the prevention of AMS were included. The incidence of AMS was our primary endpoint. Meta-regression analysis was conducted to explore factors that associated with acetazolamide efficacy. Trial sequential analyses were conducted to estimate the statistical power of the available data.RESULTS: A total of 22 trials were included. Acetazolamide at 125, 250, and 375 mg/bid significantly reduced incidence of AMS compared to placebo. TAS indicated that the current evidence was adequate confirming the efficacy of acetazolamide at 125, 250, and 375 mg/bid in lowering incidence of AMS. There was no evidence of an association between efficacy and dose of acetazolamide, timing at start of acetazolamide treatment, mode of ascent, AMS assessment score, timing of AMS assessment, baseline altitude, and endpoint altitude.CONCLUSION: Acetazolamide is effective prophylaxis for the prevention of AMS at 125, 250, and 375 mg/bid. Future investigation should focus on personal characteristics, disclosing the correlation between acetazolamide efficacy and body mass, height, degree of prior acclimatization, individual inborn susceptibility, and history of AMS.http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2021;volume=16;issue=4;spage=337;epage=346;aulast=Gaoacetazolamideacute mountain sicknesshigh altitudeprophylaxisrandomized controlled trials |
| spellingShingle | Daiquan Gao Yuan Wang Rujiang Zhang Yunzhou Zhang Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials Annals of Thoracic Medicine acetazolamide acute mountain sickness high altitude prophylaxis randomized controlled trials |
| title | Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials |
| title_full | Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials |
| title_fullStr | Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials |
| title_full_unstemmed | Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials |
| title_short | Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials |
| title_sort | efficacy of acetazolamide for the prophylaxis of acute mountain sickness a systematic review meta analysis and trial sequential analysis of randomized clinical trials |
| topic | acetazolamide acute mountain sickness high altitude prophylaxis randomized controlled trials |
| url | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2021;volume=16;issue=4;spage=337;epage=346;aulast=Gao |
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