A Trial of Acetazolamide Versus Placebo in Preventing Mountain Sickness During Rapid Ascent

Double Blind, Placebo Controlled Randomised Trial of Acetazolamide Versus Placebo in the Prevention of Acute Mountain Sickness During Rapid Ascent

Acute mountain sickness is a common ailment in people venturing over 2500 m altitude. Pilgrims to high altitudes are at an added risk since they are unaware and they gain height faster than the recommendations. Acetazolamide is the standard treatment and prophylaxis of acute mountain sickness. There are no randomized controlled trials that have studied protective effects of Acetazolamide in rapid ascent, and there are few conflicting studies regarding this matter.

This study is a randomized, double blinded, placebo controlled trial of Acetazolamide versus placebo in 380 healthy individuals travelling to Gosaikunda Lake of Nepal in rates of ascent that are faster than the recommendations. Acetazolamide 125 mg twice daily and a placebo will be randomly assigned for 3 days and participants will be assessed at 3 stations.

This study will undertake to establish the role of Acetazolamide in Rapid Ascent and will be the first RCT done in this issue.

The investigators hypothesize that Acetazolamide 125mg twice daily given before rapid ascent to high altitude in Nepalese pilgrims will not be superior to placebo in decreasing both the incidence and severity of acute mountain sickness.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

380

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Kathmandu, Nepal
        • Oxford University Clinical Research Unit Nepal

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Nepalese national
  • Aged 18 to 65
  • Travelling directly from Dhunche to Gosainkunda
  • Rapid ascent as defined by ascent within 3 days

Exclusion Criteria:

  • Use of any drugs for the prevention of altitude sickness or headache
  • Current illness
  • Current altitude sickness (more than one mild symptom on the Lake Louise Questionnaire (LLQ), or oxygen saturation less than 75%
  • Known to be pregnant or cannot exclude the possibility of being pregnant, or have missed menses by over 7 days
  • One night within the last 30 days spent at an altitude of 4500 metres or above
  • Residents of altitude more than 2500m
  • A known drug allergy to sulfonamides.
  • Treatment with any of the following in the last 2 days: acetazolamide (Diamox®), steroids (dexamethasone/decadron, prednisone), theophylline or diuretics (Lasix®), ibuprofen/motrin, naprosyn/naproxen, aspirin or acetaminophen.
  • Any serious intracranial abnormalities such as history of brain tumours or pseudotumour cerebri
  • Known severe uncontrolled headache syndrome
  • Diagnosed renal function impairment, diabetes, cirrhosis of liver or liver dysfunction

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: Placebo
Twice daily
Active Comparator: Acetazolamide
125 mg twice daily until 4380 meters altitude

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Diagnosis of acute mountain sickness
Time Frame: Upon reaching an altitude of 3300m, average expected time is 1 day
A diagnosis of AMS requires a score of three or greater on the Lake Louise Acute Mountain Sickness Questionnaire with the mandatory presence of headache and at least one of the following symptoms: dizziness or light-headedness, fatigue, gastrointestinal (GI) symptoms (nausea/vomiting), or difficulty sleeping.
Upon reaching an altitude of 3300m, average expected time is 1 day
Diagnosis of acute mountain sickness
Time Frame: Upon reaching an altitude of 4380m, average expected time is 3 days
A diagnosis of AMS requires a score of three or greater on the Lake Louise Acute Mountain Sickness Questionnaire with the mandatory presence of headache and at least one of the following symptoms: dizziness or light-headedness, fatigue, gastrointestinal (GI) symptoms (nausea/vomiting), or difficulty sleeping.
Upon reaching an altitude of 4380m, average expected time is 3 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood oxygen saturation
Time Frame: Upon reaching an altitude of 3300m, average expected time is 1 day
Percent
Upon reaching an altitude of 3300m, average expected time is 1 day
Heart rate
Time Frame: Upon reaching an altitude of 3300m, average expected time is 1 day
Beats per minute
Upon reaching an altitude of 3300m, average expected time is 1 day
High altitude headache
Time Frame: Upon reaching an altitude of 3300m, average expected time is 1 day
High altitude headache severity will be scored in milimeters based on patient markings on a visual analog scale. The headache score will be identified on the designated Lake Louise Questionnaire.
Upon reaching an altitude of 3300m, average expected time is 1 day
Blood oxygen saturation
Time Frame: Upon reaching an altitude of 4380m, average expected time is 3 days
Percent
Upon reaching an altitude of 4380m, average expected time is 3 days
Heart rate
Time Frame: Upon reaching an altitude of 4380m, average expected time is 3 days
Beats per minute
Upon reaching an altitude of 4380m, average expected time is 3 days
High altitude headache
Time Frame: Upon reaching an altitude of 4380m, average expected time is 3 days
High altitude headache severity will be scored in millimeters based on patient markings on a visual analog scale. The headache score will be identified on the designated Lake Louise Questionnaire.
Upon reaching an altitude of 4380m, average expected time is 3 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Buddha Basnyat, MD PhD, University of Oxford

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 2011

Primary Completion (Actual)

October 1, 2011

Study Completion (Actual)

October 1, 2011

Study Registration Dates

First Submitted

August 8, 2011

First Submitted That Met QC Criteria

August 15, 2011

First Posted (Estimate)

August 16, 2011

Study Record Updates

Last Update Posted (Estimate)

June 24, 2013

Last Update Submitted That Met QC Criteria

June 21, 2013

Last Verified

June 1, 2013

More Information

Terms related to this study

Other Study ID Numbers

  • 04NP

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