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
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Kathmandu, Nepal
- Oxford University Clinical Research Unit Nepal
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
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
How is the study designed?
Design Details
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo
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Twice daily
|
|
Active Comparator: Acetazolamide
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125 mg twice daily until 4380 meters altitude
|
What is the study measuring?
Primary Outcome Measures
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
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
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Buddha Basnyat, MD PhD, University of Oxford
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 04NP
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