Reappraisal of acetazolamide for the prevention of acute mountain sickness: a systematic review and meta-analysis.
نویسندگان
چکیده
Acetazolamide is used to prevent acute mountain sickness (AMS). We assessed efficacy and harm of acetazolamide for the prevention of AMS, and tested for dose-responsiveness. We systematically searched electronic databases (until April 2011) for randomized trials comparing acetazolamide with placebo for the prevention of AMS. For each dose, risk ratios were aggregated using a Mantel-Haenszel fixed effect model. Numbers needed to treat (NNT) to benefit one subject with each dose were calculated for different baseline risks. Modes of ascent were taken as proxies of baseline risks. Twenty-four trials were included; 1011 subjects received acetazolamide 250, 500, or 750 mg day⁻¹; 854 received placebo. When climbing, median speed of ascent was 14 m/h, average AMS rate in controls was 34%, and NNT to prevent AMS with acetazolamide 250, 500, and 750 mg/day compared with placebo was 6.5, 5.9, and 5.3. When ascending by transport and subsequent climbing (speed of ascent 133 m/h) or by transport alone (491 m/h), average AMS rate in controls was 60%, and NNT with acetazolamide 250, 500, and 750 mg/day was 3.7, 3.3, and 3.0. In hypobaric chambers, median speed of ascent was 4438 m/h, average AMS rate in controls was 86%, and NNT with acetazolamide 250, 500, and 750 mg/day was 2.6, 2.3, and 2.1. The risk of paresthesia was increased with all doses. The risk of polyuria and taste disturbance was increased with 500 and 750 mg/day. The degree of efficacy of acetazolamide for the prevention of AMS is limited when the baseline risk is low, and there is some evidence of dose-responsiveness.
منابع مشابه
Identifying the lowest effective dose of acetazolamide for the prophylaxis of acute mountain sickness: systematic review and meta-analysis
OBJECTIVES To assess the efficacy of three different daily doses of acetazolamide in the prevention of acute mountain sickness and to determine the lowest effective dose. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline and Embase along with a hand search of selected bibliographies. No language restrictions were applied. STUDY SELECTION Randomised controlled trials assessi...
متن کاملEfficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review.
OBJECTIVE To quantify efficacy and harm of pharmacological prevention of acute mountain sickness. DATA SOURCES Systematic search (Medline, Embase, Cochrane Library, internet, bibliographies, authors) in any language, up to October 1999. STUDY SELECTION Randomised placebo controlled trials. DATA EXTRACTION Dichotomous data on efficacy and harm from 33 trials (523 subjects received 13 diffe...
متن کاملEfficacy of NSAIDs for the prevention of acute mountain sickness: a systematic review and meta-analysis
BACKGROUND Acute mountain sickness (AMS) can occur in anyone going to a high altitude. Non-steroidal anti-inflammatory drugs (NSAIDs) have been studied for the prevention of AMS with mixed results. In this systematic review, we analyze all existing data on the use of NSAIDs to prevent AMS using the Lake Louise Scoring System (LLSS) in different randomized clinical trials (RCTs). METHODS Elect...
متن کاملAcetazolamide in prevention of acute mountain sickness: a double-blind controlled cross-over study.
Twenty-four amateur climbers took part in a double-blind controlled cross-over trial of acetazolamide versus placebo for the prevention of acute mountain sickness. They climbed Kilimanjaro (5895 m) and Mt Kenya (5186 m) in three weeks with five rest days between ascents. The severity of acute mountain sickness was gauged by a score derived from symptoms recorded daily by each subject. On kilima...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- High altitude medicine & biology
دوره 13 2 شماره
صفحات -
تاریخ انتشار 2012