Comparative effects of pharmacological interventions for the prevention of acute mountain sickness: A systematic review and Bayesian network meta-analysis
Abstract
Background: Acute Mountain Sickness (AMS), the most prevalent high-altitude illness, necessitates effective preventive measures due to rising sudden high-altitude exposure from tourism and occupational activities. Current Pharmacological prophylaxis lack robust comparisons, dose optimization, and confounder-adjusted analysis.
Methods: This network meta-analysis (NMA) included 28 randomized controlled trials (RCTs), evaluated healthy individuals with a rapid ascent to >2500 m, compared 13 drugs for AMS incidence, severe AMS (SAMS) incidence, Lake Louise Score (LLS), peripheral oxygen saturation (SpO2), and pulmonary artery pressure (PAP). Quality was evaluated using Cochrane Risk of Bias tools and CINeMA (Confidence in Network Meta-Analysis) for evidence grading. Network meta-regression adjusted for ascent altitude and exposure duration to identify "time" windows or "height" windows.
Results: 250 mg BID acetazolamide (OR = 0.31, 95 %CI: 0.20-0.47) demonstrated a 5-day preventive efficacy window, while 375 mg BID acetazolamide (OR = 0.31, 95 %CI: 0.18-0.54) showed a shorter 3-day window. 4 mg BID dexamethasone (OR = 0.29, 95 %CI: 0.16-0.54) and 600 mg TID ibuprofen (OR = 0.44, 95 %CI: 0.3-0.64) also significantly reduced AMS incidence. No pharmacological interventions reduced SAMS incidence. After altitude adjustment, sildenafil (40 mg TID; MD = -1.11, 95 %CI: 2.01-0.25) attenuated altitude-induced PAP elevation.
Conclusion: Moderate-dose acetazolamide (125-250 mg BID)…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Drug repositioning: a brief overview
- Cyclic nucleotide phosphodiesterases in Drosophila melanogaster
- Time-resolved in silico modeling of fine-tuned cAMP signaling in platelets: feedback loops, titrated phosphorylations and pharmacological modulation
- Current View on Green Tea Catechins Formulations, Their Interactions with Selected Drugs, and Prospective Applications for Various Health Conditions
- In silico Structure-based Identification of Novel Acetylcholinesterase Inhibitors Against Alzheimer’s Disease
- Development and In Vitro Evaluation of Controlled Release Viagra® Containing Poloxamer-188 Using Gastroplus™ PBPK Modeling Software for In Vivo Predictions and Pharmacokinetic Assessments
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.