Study Casts Doubt on Effectiveness of COPD Drug

A widely used drug may not significantly reduce the amount of time that patients with the lung condition COPD require mechanical help to breathe, a new study suggests.

COPD (chronic obstructive pulmonary disease) — which is often related to smoking — includes emphysema, chronic bronchitis or a combination of the two. Common symptoms include difficulty breathing, chronic cough, wheezing and phlegm production. Over time, the condition can prove fatal.

The drug acetazolamide has been used for decades to help COPD patients breathe when they develop a dangerous condition called metabolic alkalosis.

However, the French study authors said that, until now, there’s been no clinical trial to prove that the drug is actually effective in such cases.

To try to remedy that situation, the new study included 380 French COPD patients who were expected to receive mechanical ventilation (help with breathing) for more than 24 hours.

The findings were published in the Feb. 2 issue of the Journal of the American Medical Association.

For the study, each patient was given either acetazolamide or an inactive placebo. Treatment began within 48 hours of the patients being admitted to an intensive care unit (ICU) and continued for a maximum of 28 days, the authors said in a journal news release.

According to the team, led by Dr. Christophe Faisy of the European Georges Pompidou Hospital in Paris, there were no “significant” differences between the two groups in how long they spent on mechanical ventilation, the length of their ICU stay, or their death rates while in the ICU.

One expert in the United States said that the study could be an important one for COPD patients.

“It’s important to look at treatment protocols in this fashion, so that treatments that offer no advantage — but could have a downside as well — are not routinely used,” said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.

However, another U.S. expert differed with the French investigators on their definition of what “significant” improvements might mean for a patient.

Dr. Alan Mensch is chief of pulmonary medicine at Northwell Health’s Plainview Hospital in Plainview, N.Y. He noted that, according to the French research team, people who received acetazolamide required 16 fewer hours on the ventilator compared to those who received the placebo.

“In addition, the treated group had improved oxygen levels,” Mensch said.

“This suggests that a larger study is needed to obtain statistical significance in order to establish a beneficial effect of acetazolamide for patients on respirators,” he said, and “this study should be considered preliminary.”

More information

The U.S. National Heart, Lung, and Blood Institute has more on COPD.

Source: HealthDay

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