[Almitrine dimesylate: deductions and therapeutic prospects]

When administered orally, in the usual doses, to chronic bronchitis patients with hypoxaemia and hypercapnia, almitrine bismesylate corrects blood gas disturbances without producing significant changes in haemodynamic and spirometric values. This effect betrays a specific action on the alveolar ventilation/perfusion imbalance responsible for hypoxaemia. The original mode of action of the drug and its clinical and biological effectiveness demonstrated in long-term treatment, as well as its safety, offer new hopes for the management of chronic bronchitis. The possibility of acting on hypoxaemia conveniently and at an early stage should be expected to delay the development of cor pulmonale, but this remains hypothetical and needs to be confirmed, in spite of strong physiopathological bases, by strictly controlled therapeutic trials. It cannot be definitely stated, at this stage, that almitrine will entirely replace continuous low flow rate oxygen therapy, yet it is already certain that the indications for the latter ought to be re-evaluated for physiopathological, practical and financial reasons.