title: One year treatment with almitrine improves hypoxaemia but does not increase pulmonary artery pressure in COPD patients.
abstract: Almitrine bismesylate, a chemoreceptor agonist, improves hypoxaemia in a high percentage of chronic obstructive pulmonary disease (COPD) patients and its long-term use may thus be of interest in these patients. The course of pulmonary haemodynamics during a one year treatment was investigated in severe COPD patients (forced expiratory volume in one second FEV1 = 1,040 +/- 80 SEM ml) with persistent hypoxaemia (initial arterial oxygen tension (PaO2) in the range 6.6-8.6 kPa (50-65 mmHg]. Patients were given either almitrine (A, n = 27), 100 mg.day-1, during two consecutive months per quarter followed by a one month wash-out period (intermittent "schedule"), or placebo (P, n = 18) with the same schedule. Eleven patients in group A and 8 in group P could not complete the one year study because of lack of compliance, worsening of respiratory insufficiency, or for other reasons. In the remaining patients, PaO2 significantly increased in group A (n = 16) from 7.6 +/- 0.1 to 8.3 +/- 0.2 kPa (56.9 +/- 1.0 to 62.7 +/- 1.7 mmHg) (p less than 0.001) but not in group P (n = 10) from 7.5 +/- 0.3 to 7.9 +/- 0.3 kPa (56.1 +/- 2.3 to 59.1 +/- 2.1 mmHg). PaCO2 did not significantly change in either group. Pulmonary artery mean pressure (PAP) was stable in both groups: from 26.8 +/- 2.1 to 25.4 +/- 1.9 mmHg in group A, and from 20.6 +/- 1.1 to 20.9 +/- 1.5 mmHg in group P.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Hôpital Universitaire, Strasbourg, France.
authors.forename: E
authors.initials: E
authors.lastname: Weitzenblum
authors.forename: F
authors.initials: F
authors.lastname: Schrijen
authors.forename: M
authors.initials: M
authors.lastname: Apprill
authors.forename: C
authors.initials: C
authors.lastname: Prefaut
authors.forename: J C
authors.initials: JC
authors.lastname: Yernault
mesh_terms: D000328:Adult; D000368:Aged; D015765:Almitrine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D004311:Double-Blind Method; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008173:Lung Diseases, Obstructive / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011651:Pulmonary Artery / Q000187:drug effects* / Q000503:physiopathology; D015656:Respiratory Mechanics / Q000187:drug effects; D013997:Time Factors; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D015765:Almitrine; D010100:Oxygen