Acetazolamide for Monge's Disease: Efficiency and Tolerance of 6 …
Source: RedOrbit (Original Article)
Acetazolamide for Monge’s Disease: Efficiency and Tolerance of 6- Month Treatment
Posted on: Tuesday, 17 June 2008, 03:00 CDT
By Richalet, Jean-Paul Rivera-Ch, Maria; Maignan, Maxime; Privat, Catherine; Pham, Isabelle; Macarlupu, Jose-Luis; Petitjean, Olivier; Leon-Velarde, Fabiola Rationale: Monge’s disease is characterized by an excessive erythrocytosis, frequently associated with pulmonary hypertension, in high-altitude dwellers. It has a considerable impact on public health in high-altitude regions. A preliminary study demonstrated the efficiency of acetazolamide (Acz) (250 mg/d for 3 wk) in reducing serum erythropoietin and hematocrit. Objectives: Evaluate the efficacy and tolerance of a 6-month treatment with 250mgAcz that could be chronically implemented and its effects on pulmonary artery pressure and cardiac function. Methods: A two-phase study was performed in patients (hematocrit >/= 63%) from Cerro de Pasco, Peru (4,300 m). First phase: a doubleblind, placebo-controlled study in 55 patients who received a single dose of either 250 mg Acz (n = 40) or placebo (n = 15) by daily oral administration for 12 weeks. Second phase (open label): after a 4-week washout period, all patients received 250mgAcz for 12 weeks. Hematocrit, blood gases, clinical outcome, and pulmonary artery circulation were evaluated. Measurements and Main Results: First phase: Acz decreased by 44% the number of polycythemic subjects (P = 0.02), decreased hematocrit from 69 to 64% (P Conclusions: Acz reduces erythrocytosis and improves pulmonary circulation in Monge’s disease without adverse effects. Its implementation as a chronic treatment for this disease appears efficient and safe. Clinical trial registered with www.clinicaltrials.gov (NCT 00424970). Keywords: hypoxia; altitude; pulmonary hypertension; chronic mountain sickness Monge’s disease or chronic mountain sickness (CMS) is characterized by an excessive erythrocytosis (hemoglobin concentration > travelnews 21 g/dl or hematocrit > 63%) …continue reading