[The first Italian clinical experience with almitrine bismesylate]

A double blind randomised multicentre clinical trial against placebo was performed in Italy on 128 patients with chronic airflow obstruction and hypoxaemia. On entry to the study all the patients were hypoxaemic (PaO2 less than or equal to 70 mmHg), 22 were normocapnic (PaCO2 less than or equal to 41 mmHg), 106 hypercapnic (PaCO2 greater than or equal to 43 mmHg). The patients (107 males and 21 females) with a mean age of 64 received oral Almitrine bismesylate for two months in a dose of 100 mg per day or placebo taken in two doses with the main meals. After inclusion in the study (TO), patients were reviewed after 30 and 60 days of treatment to evaluate pulmonary function and blood gases. The results were as follows: Almitrine bismesylate did not produce any significant variations in lung volumes, tests of airflow obstruction (for large or small airways) or the distribution of intra-pulmonary inspired air. The blood gas values at the end of treatment showed statistically significant changes (p less than 0.001: PaCO2 + 7.6 mmHg in patients overall and PaCO2 - 4.1 mmHg in those patients with hypercapnia.) The changes in arterial blood, already apparent after 30 days, were even more marked at the end of the study. These favourable blood gas changes might be the result (for the greater part) of the intra-pulmonary haemodynamic effect induced by Almitrine bismesylate (improved VA/QC ratios described in the literature) and (for a smaller part) a better ventilatory pattern with a reduction in the (A-a) DO2 and the functional dead space.(ABSTRACT TRUNCATED AT 250 WORDS)