Effect of acetazolamide on altitude-induced impairment in postural control in patients with COPD. RCT

Abstract

Introduction: Patients with chronic obstructive pulmonary disease (COPD) have impaired postural control (PC) already at sea level which deteriorates with altitude. The current randomized, placebo-controlled, double-blind trial evaluates the effectiveness of acetazolamide (AZA) in preventing PC impairment in lowlanders with COPD travelling to 3100m. Methods: 127 COPD patients, FEV1 ≥40% to Results: With ascent to 3100m, patients in the placebo group had a mean±SD increase of PL from 28.78±9.68 to 30.04±9.95cm (P=0.002). In the AZA group the change from 27.64±9.61 to 28.38±9.65cm was not significant (P=0.069). The mean difference between groups in altitude-induced PL change (treatment effect) was -0.54cm (95%CI -1.66 to 0.58, P=0.289). Regression analysis controlling for potential confounders confirmed an increase in PL with altitude (0.98cm, 95%CI 0.39 to 1.58, P=0.001) and no effect of AZA (0.66cm, 95%CI -0.25 to 1.57, P=0.156). PL changes were seen mostly in the anteroposterior (AP) plane with worsening of the AP sway amplitude of 0.3cm (95%CI 0.15 to 0.45) with AZA (P Conclusions: Postural control in patients with COPD staying 24h at 3100m was impaired and AZA had no beneficial effects. Grant: Swiss National Science Foundation, Lunge Zurich