Clinical observation of Metazolamide in the treatment of normal pressure hydrocephalus / 中华老年医学杂志

ABSTRACT

Objective:To study the efficacy and safety of Methazolamide(MTZ)for the treatment of normal pressure hydrocephalus(NPH)patients.Methods:A randomized, double-blind, placebo-controlled, prospective clinical study was conducted in Aviation General Hospital.A total of 35 NPH patients including 29 idiopathic normal pressure hydrocephalus(iNPH)and 6 secondary normal pressure hydrocephalus(sNPH)received drug treatment in our hospital from September 2019 to March 2021.All patients were unsuitable for or refused surgical treatment for some reasons.The patients were divided into drug group(n=18)and control group(n=10), taking oral MTZ or placebo 25 mg twice daily, increasing to 50 mg twice daily after 1 week if there was no discomfort.The 10 m gait score, cognitive function score, brain MRI check were completed before and 1 month after oral administration.The assessment of idiopathic normal pressure hydrocephalus scale(iNPHGS)score were performed 1 month and 3 months after oral administration.The primary efficacy endpoint was iNPHGS score for 3 months treatment and the secondary efficacy endpoint was the assessment of above scales for 1 month treatment.Results:As compared with baseline, the effect of 1 month treatment showed that MOCA scores[(16.2±8.8)and(14.8±8.7)scores, t=-2.68, P=0.02], 10 m gait scores[(22.3±11.2)and(25.6±12.9), t=2.76, P=0.02], iNPHGS scores[(7.3±3.2)and(8.1±3.5), t=4.08, P<0.01]were improved.The effect of 3 month treatment showed that the iNPHGS score(6.1±2.4)was improved compared with baseline( t=5.07, P<0.01)and 1 month( t=4.11, P<0.01). But the above scores of the control group were not significantly improved compared with the baseline(all P>0.05). After 1 month treatment, the 10 m gait score and iNPHGS score in the drug group were improved compared with those in the control group(all P<0.05). After 3 months treatment, the iNPHGS score was improved compared with the baseline level in the control group( t=-4.41, P<0.05). The above 35 patients had no serious adverse reactions such as hypokalemia and acidosis.There was no significant difference in adverse events between the two groups( χ2=0.01, P=1.00). Conclusions:The treatment of MTZ could effectively improve the clinical symptoms of NPH patients with good safety.