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Efficacy of NSAIDs for the prevention of acute mountain sickness: a systematic review and meta-analysis

BACKGROUND: Acute mountain sickness (AMS) can occur in anyone going to a high altitude. Non-steroidal anti-inflammatory drugs (NSAIDs) have been studied for the prevention of AMS with mixed results. In this systematic review, we analyze all existing data on the use of NSAIDs to prevent AMS using the...

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Autores principales: Pandit, Anil, Karmacharya, Paras, Pathak, Ranjan, Giri, Smith, Aryal, Madan R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185145/
https://www.ncbi.nlm.nih.gov/pubmed/25317267
http://dx.doi.org/10.3402/jchimp.v4.24927
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author Pandit, Anil
Karmacharya, Paras
Pathak, Ranjan
Giri, Smith
Aryal, Madan R.
author_facet Pandit, Anil
Karmacharya, Paras
Pathak, Ranjan
Giri, Smith
Aryal, Madan R.
author_sort Pandit, Anil
collection PubMed
description BACKGROUND: Acute mountain sickness (AMS) can occur in anyone going to a high altitude. Non-steroidal anti-inflammatory drugs (NSAIDs) have been studied for the prevention of AMS with mixed results. In this systematic review, we analyze all existing data on the use of NSAIDs to prevent AMS using the Lake Louise Scoring System (LLSS) in different randomized clinical trials (RCTs). METHODS: Electronic literature searches for relevant studies were identified through MEDLINE, EMBASE, SCOPUS, and Cochrane library up to June 2013. RCTs involving NSAIDs compared to placebo in patients undergoing ascent to a height of at least 3,800 m were included. Odds ratios (OR) were calculated and combined using fixed-effect model meta-analysis if I (2)=0%. Differences between groups were calculated using the inverse variance of the standard mean differences. Between-study heterogeneity was assessed using the I (2) statistics. RESULTS: In three clinical trials involving 349 patients, AMS using LLSS occurred in 26.92% of patients on NSAIDs and 43.71% on placebo (OR 0.43; CI [confidence interval] 0.27–0.69, I (2)=0%, p=0.0005), NNT=6. Minor outcome of end point Spo2 was not significant in the two groups (IV=0.74; 95% CI −0.20–1.69, I (2)=81%, p=0.12). Similarly, a change in Spo2 from baseline was also not significant in the two groups (IV=0.05; 95% CI −0.28–0.37, I (2)=44%, p=0.78). CONCLUSION: NSAIDs might be a safe and effective alternative for the prevention of AMS. However, further larger population studies and studies comparing NSAIDs to acetazolamide and dexamethasone in the future may provide further data to its relative efficacy.
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spelling pubmed-41851452014-10-14 Efficacy of NSAIDs for the prevention of acute mountain sickness: a systematic review and meta-analysis Pandit, Anil Karmacharya, Paras Pathak, Ranjan Giri, Smith Aryal, Madan R. J Community Hosp Intern Med Perspect Review Article BACKGROUND: Acute mountain sickness (AMS) can occur in anyone going to a high altitude. Non-steroidal anti-inflammatory drugs (NSAIDs) have been studied for the prevention of AMS with mixed results. In this systematic review, we analyze all existing data on the use of NSAIDs to prevent AMS using the Lake Louise Scoring System (LLSS) in different randomized clinical trials (RCTs). METHODS: Electronic literature searches for relevant studies were identified through MEDLINE, EMBASE, SCOPUS, and Cochrane library up to June 2013. RCTs involving NSAIDs compared to placebo in patients undergoing ascent to a height of at least 3,800 m were included. Odds ratios (OR) were calculated and combined using fixed-effect model meta-analysis if I (2)=0%. Differences between groups were calculated using the inverse variance of the standard mean differences. Between-study heterogeneity was assessed using the I (2) statistics. RESULTS: In three clinical trials involving 349 patients, AMS using LLSS occurred in 26.92% of patients on NSAIDs and 43.71% on placebo (OR 0.43; CI [confidence interval] 0.27–0.69, I (2)=0%, p=0.0005), NNT=6. Minor outcome of end point Spo2 was not significant in the two groups (IV=0.74; 95% CI −0.20–1.69, I (2)=81%, p=0.12). Similarly, a change in Spo2 from baseline was also not significant in the two groups (IV=0.05; 95% CI −0.28–0.37, I (2)=44%, p=0.78). CONCLUSION: NSAIDs might be a safe and effective alternative for the prevention of AMS. However, further larger population studies and studies comparing NSAIDs to acetazolamide and dexamethasone in the future may provide further data to its relative efficacy. Co-Action Publishing 2014-09-29 /pmc/articles/PMC4185145/ /pubmed/25317267 http://dx.doi.org/10.3402/jchimp.v4.24927 Text en © 2014 Anil Pandit et al. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Pandit, Anil
Karmacharya, Paras
Pathak, Ranjan
Giri, Smith
Aryal, Madan R.
Efficacy of NSAIDs for the prevention of acute mountain sickness: a systematic review and meta-analysis
title Efficacy of NSAIDs for the prevention of acute mountain sickness: a systematic review and meta-analysis
title_full Efficacy of NSAIDs for the prevention of acute mountain sickness: a systematic review and meta-analysis
title_fullStr Efficacy of NSAIDs for the prevention of acute mountain sickness: a systematic review and meta-analysis
title_full_unstemmed Efficacy of NSAIDs for the prevention of acute mountain sickness: a systematic review and meta-analysis
title_short Efficacy of NSAIDs for the prevention of acute mountain sickness: a systematic review and meta-analysis
title_sort efficacy of nsaids for the prevention of acute mountain sickness: a systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185145/
https://www.ncbi.nlm.nih.gov/pubmed/25317267
http://dx.doi.org/10.3402/jchimp.v4.24927
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