Ansquer J C
Eur J Respir Dis Suppl. 1986;146:703-12.
The aim of the VIMS group is to verify the efficacy and acceptability of almitrine bismesylate (ABM) taken orally in the treatment of chronic obstructive bronchitis, by an international long-term study, one year controlled against placebo. This study includes more than 800 out-patients in 70 centres in 12 countries. 490 patients entered the study before 1/1/84, after the first 9 months of the inclusion period. 60% of patients are treated in France, 20% in the U.K. and Ireland and 20% in Belgium, Denmark, Italy, Switzerland. Their mean FEV1 is 0.87 liters, their mean PaO2 is 57 mmHg. The study protocol foresees two control visits separated by a 3 week interval before entry into the study in order to verify the stability of the patients on the basis of clinical, spirometric and gazometric data; the variation in PaO2 is less than or equal to 6 mmHg in more than 90% of the patients. The severity of the disease is assessed by the existence of an hospitalisation during the year preceeding the study in 55% of the patients, the necessity of oxygenotherapy at home for at least 12hr/day in 1/3 of them. The treatment of the latter was attributed separately at random to seek in a prospective manner the interest of associating O2 and ABM. During the study, the mortality of the patients included is 6% and about 70% of the patients completed the study period. The survey of adverse reactions and reasons for treatment interruption is progressively established by close collaboration between the investigators and monitors, to comply with the directives of pharmacosurveillance for severe and polymedicated patients. The analysis of the results to be carried out at the end of the study after verification and correction by the investigators, should enable us to enhance our knowledge of the clinical and gazometric parameters in patients with chronic obstructive disease followed for one year and treated by conventional means (control group) and the activity of ABM in order to confirm its therapeutic value in the treatment of chronic obstructive bronchitis.
VIMS 研究组的目的是通过一项为期一年、设安慰剂对照的国际长期研究,验证口服二甲磺酸阿米三嗪(ABM)治疗慢性阻塞性支气管炎的疗效和可接受性。该研究涵盖了12个国家70个中心的800多名门诊患者。490名患者在纳入期的前9个月后于1984年1月1日前进入研究。60%的患者在法国接受治疗,20%在英国和爱尔兰,20%在比利时、丹麦、意大利、瑞士。他们的平均第一秒用力呼气容积(FEV1)为0.87升,平均动脉血氧分压(PaO2)为57毫米汞柱。研究方案预计在进入研究前进行两次间隔3周的对照访视,以便根据临床、肺功能和气体分析数据验证患者的稳定性;超过90%的患者PaO2变化小于或等于6毫米汞柱。55%的患者在研究前一年有过住院史,三分之一的患者需要在家中每天至少吸氧12小时,以此评估疾病的严重程度。对后者的治疗被随机分别分配,以前瞻性方式探寻联合使用氧气和ABM的益处。在研究期间,纳入患者的死亡率为6%,约70%的患者完成了研究期。研究者和监测者密切合作,逐步建立不良反应及治疗中断原因的调查,以符合针对重症和多种药物治疗患者的药物监测指令。研究结束时,经研究者核实和校正后进行结果分析,应能使我们增进对慢性阻塞性疾病患者临床和气体分析参数的了解(对照组采用传统方法治疗),以及ABM的活性,从而确认其在治疗慢性阻塞性支气管炎方面的治疗价值。