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...

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Autores principales:	Daiquan Gao, Yuan Wang, Rujiang Zhang, Yunzhou Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2021
Materias:	acetazolamide acute mountain sickness high altitude prophylaxis randomized controlled trials Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/b4d1ec8703a641b29bdec8b6c8676523
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spelling	oai:doaj.org-article:b4d1ec8703a641b29bdec8b6c86765232021-11-12T10:08:17ZEfficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials1817-17371998-355710.4103/atm.atm_651_20https://doaj.org/article/b4d1ec8703a641b29bdec8b6c86765232021-01-01T00:00:00Zhttp://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2021;volume=16;issue=4;spage=337;epage=346;aulast=Gaohttps://doaj.org/toc/1817-1737https://doaj.org/toc/1998-3557BACKGROUND: 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.Daiquan GaoYuan WangRujiang ZhangYunzhou ZhangWolters Kluwer Medknow Publicationsarticleacetazolamideacute mountain sicknesshigh altitudeprophylaxisrandomized controlled trialsDiseases of the circulatory (Cardiovascular) systemRC666-701Diseases of the respiratory systemRC705-779ENAnnals of Thoracic Medicine, Vol 16, Iss 4, Pp 337-346 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acetazolamide acute mountain sickness high altitude prophylaxis randomized controlled trials Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the respiratory system RC705-779
spellingShingle	acetazolamide acute mountain sickness high altitude prophylaxis randomized controlled trials Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the respiratory system RC705-779 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
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.
format	article
author	Daiquan Gao Yuan Wang Rujiang Zhang Yunzhou Zhang
author_facet	Daiquan Gao Yuan Wang Rujiang Zhang Yunzhou Zhang
author_sort	Daiquan Gao
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_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_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_sort	efficacy of acetazolamide for the prophylaxis of acute mountain sickness: a systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials
publisher	Wolters Kluwer Medknow Publications
publishDate	2021
url	https://doaj.org/article/b4d1ec8703a641b29bdec8b6c8676523
work_keys_str_mv	AT daiquangao efficacyofacetazolamidefortheprophylaxisofacutemountainsicknessasystematicreviewmetaanalysisandtrialsequentialanalysisofrandomizedclinicaltrials AT yuanwang efficacyofacetazolamidefortheprophylaxisofacutemountainsicknessasystematicreviewmetaanalysisandtrialsequentialanalysisofrandomizedclinicaltrials AT rujiangzhang efficacyofacetazolamidefortheprophylaxisofacutemountainsicknessasystematicreviewmetaanalysisandtrialsequentialanalysisofrandomizedclinicaltrials AT yunzhouzhang efficacyofacetazolamidefortheprophylaxisofacutemountainsicknessasystematicreviewmetaanalysisandtrialsequentialanalysisofrandomizedclinicaltrials
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Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials

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