Effect of Acetazolamide vs Placebo on Duration of Invasive Mechanical Ventilation Among Patients With Chronic Obstructive Pulmonary Disease A Randomized Clinical Trial

Chronic Obstructive Pulmonary disease(COPD) is a series of lung diseases that make it extremely difficult for persons affected with this disease to breath properly. It is a frequent cause of ICU admissions. Treatment requires invasive mechanical ventilation because noninvasive ventilation methods often are not successful at alleviating the effects of this disease.

Acetalzolamide is a medication used as a noninvasive method of relieving COPD symptoms. However this medication does not have the FDA indication to treat COPD and no studies were done to see if this medication was even effective in doing such. This article is a double blind study that had patients taking 500-1ooo mg of Acetazolamide to test its effectiveness as a COPD treating agent.

The results of the study actually found that there was NO difference in symptoms when Acetazolamide was administered. However, it is important to note that the researchers conducting the study, said that certain aspects of the study could have been underpowered to establish statistical significance.

Why was this drug allowed to be used for so long to treat a condition it was not FDA approved to treat without first having thorough research done proving its efficacy? What does this mean or how does this change the ways in which we introduce a new drug therapy?

Citation:

Faisy C, Meziani F, Planquette B, et al. Effect of Acetazolamide vs Placebo on Duration of Invasive Mechanical Ventilation Among Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial. JAMA. 2016;315(5):480-488. doi:10.1001/jama.2016.0019.

2 thoughts on “Effect of Acetazolamide vs Placebo on Duration of Invasive Mechanical Ventilation Among Patients With Chronic Obstructive Pulmonary Disease A Randomized Clinical Trial”

  1. This is a pretty puzzling article to bring up. Why would physicians choose to use a medication to treat a disease of which the medication was not proven to treat? Perhaps there should be some sort of disclaimer given to patients when a physician prescribes a medication not FDA indicated to treat a disease. There are certainly many illnesses that can be treated with non-FDA indicated medications, but often even this use is well documented in some other study and the FDA has yet to approve the indication. However, it still baffles me that this drug was used for such a long period of time for this disease state without proper testing. It makes me a little more skeptical about the medications physicians choose in practice, but I believe that generally FDA labeled indications should be followed.

    1. Bouncing off of Phil’s ideas, I believe that it is important for doctors to include diagnosis information on prescriptions to ensure that the proper medication is being used for the proper condition. Last semester, we had a pharmacist come in (can’t remember who it was) who worked with cancer patients and he was explaining to us about a time that a doctor had written out a prescription for a treatment that the pharmacist didn’t think the patient could benefit from. The doctor was then asked to provide some evidence for his decision (in the form of literature) and he could not. As a result, it became an ethical decision for the pharmacist to fill or not to fill the prescription. If information like this was reviewed in all pharmacies, then errors in prescribing like cited in the article could be preventable.

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