| Design | Randomised trial at 42 centres |
|---|---|
| Treatment | Long-term supplemental oxygen |
| Control | No long-term supplemental oxygen |
| Population | 738 patients with stable COPD and resting or exercise-induced moderate desaturation |
| Follow-up | 1 to 6 years |
| Primary endpoint | Time to death or first hospitalisation |
| Result | No significant difference in time to death or first hospitalisation (HR 0.94, 95% CI 0.79 to 1.12, p=0.52). No difference in all hospitalisations (rate ratio 1.01), COPD exacerbations (1.08) or COPD-related hospitalisations (0.99). No consistent differences in quality of life, lung function or six-minute walk distance. |
| Secondary endpoints | Hospitalisation rates, exacerbations, quality of life, lung function, six-minute walk distance |
In patients with stable COPD and resting or exercise-induced moderate desaturation, the prescription of long-term supplemental oxygen did not result in a longer time to death or first hospitalization than no long-term supplemental oxygen, nor did it provide sustained benefit with regard to any of the other measured outcomes.
The trial authors, in the published abstract
Drew the line that NOTT and MRC oxygen left undrawn. Long-term oxygen works for severe resting hypoxaemia and does not work for moderate desaturation — a distinction that stopped a great deal of unnecessary prescribing.
Albert RK, Au DH, Blackford AL, et al. A Randomized Trial of Long-Term Oxygen for COPD with Moderate Desaturation. N Engl J Med 2016 Oct 27;375(17):1617-1627.