[Sequential administration of a reduced dose of almitrine to patients with chronic obstructive bronchopneumopathies. A controlled multicenter study].
Recent multi-centre studies have shown that high doses of Almitrine (100-200 mg per day), lead to a significant improvement in the hypoxaemia of patients presenting with chronic airflow obstruction, but that a high blood level (greater than 500 ng/ml) is often seen after 1 year, sometimes associated with signs of peripheral neuropathy. In order to maintain Almitrine blood levels in the range 200-300 ng/ml we have used an intermittent regime (with a "window" of 1 month every 3 months) and a dose limited to 100 mg per day. 102 hypoxic patients with chronic airflow obstruction, who were in a stable state were included. 65 patients were in the Almitrine group (A) and 37 patients in the placebo group (P). The treatment lasted for 1 year. In addition there was a 3 monthly follow up with arterial blood gases and spirometry, a clinical neurological examination and also electrophysiology, initially and after 6 and 12 months. 43% of patients in group A and 32% of patients in group P, left the study, most often due to poor cooperation, but sometimes as a result of side effects. After 12 months the PaO2 rose significantly in group A from 59.1 +/- 0.7 to 65.8 +/- 1.6 mmHg (p less than 0.001) whilst it was not changed in group P. The PaCO2 did not change in either group. On the other hand there was a significant fall in the subgroup of patients with hypercapnia in group A (p less than 0.001). The outcome of the neurological and electrophysiological assessments did not show any significant difference between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Weitzenblum
E
E
Service de Pneumologie, Hôpital de Hautepierre, CHRU, Strasbourg.
Arnaud
F
F
Bignon
J
J
Boutin
C
C
Brune
J
J
Castaing
Y
Y
Courty
G
G
Derenne
J
J
Duroux
P
P
Fréour
P
P
D000328:Adult; D000368:Aged; D015765:Almitrine / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010525:Peripheral Nerves / Q000187:drug effects / Q000502:physiology; D012129:Respiratory Function Tests; D013997:Time Factors
D015765:Almitrine
Administration séquentielle d'une posologie réduite d'almitrine à des malades BPCO. Etude multicentrique contrôlée.