Abstract
Does sertraline provide symptomatic relief for chronic breathlessness in people with advanced disease whose underlying cause(s) are optimally treated?
223 participants with chronic breathlessness (modified Medical Research Council breathlessness scale ≥2) who had optimal treatment of underlying cause(s) were randomised 1:1 to sertraline 25–100 mg (titrated upwards over 9 days) or placebo for 4 weeks. The primary outcome was the proportion who had an improvement in intensity of current breathlessness >15% from baseline on a 100-mm visual analogue scale.
The proportion of people responding to sertraline was similar to placebo for current breathlessness on days 26–28 (OR 1.00, 95% CI 0.71–1.40) and for other measures of breathlessness. Quality of life in the sertraline arm had a higher likelihood of improving than in the placebo arm over the 4 weeks (OR 0.21, 95% CI 0.01–0.41; p=0.044). No differences in performance status, anxiety and depression, or survival were observed. Adverse event rates were similar between arms.
Sertraline does not appear to provide any benefit over placebo in the symptomatic relief of chronic breathlessness in this patient population.
Abstract
Chronic breathlessness generates suffering late in life. In this setting, titrated sertraline had similar benefits and harms to placebo in an adequately powered, multi-site, double blind, randomised controlled trial at 4 weeks. http://ow.ly/iWtH30mcMYK
Footnotes
This study is registered at www.anzctr.org.au with identifier number ACTRN 12610000464066. Data are available on request from bona fide researchers.
Conflict of interest: D.C. Currow has received an unrestricted research grant from Mundipharma, is an unpaid member of an advisory board for Helsinn Pharmaceuticals and has consulted to Mayne Pharma and received intellectual property payments from them. He is a paid consultant to Specialist Therapeutics.
Conflict of interest: M. Ekström has nothing to disclose.
Conflict of interest: S. Louw reports personal fees for statistic consultation from Palliative Care Clinical Studies Collaborative, during the conduct of the study.
Conflict of interest: J. Hill has nothing to disclose.
Conflict of interest: B. Fazekas has nothing to disclose.
Conflict of interest: K. Clark has nothing to disclose.
Conflict of interest: P.M. Davidson has nothing to disclose.
Conflict of interest: C. McDonald reports personal fees for speaking from GSK and Novartis, personal fees for advisory board work from Pfizer, and fees for speaking that were paid directly to the hospital from Menarini, outside the submitted work.
Conflict of interest: D. Sajkov has nothing to disclose.
Conflict of interest: N. McCaffrey has nothing to disclose.
Conflict of interest: M. Doogue has nothing to disclose.
Conflict of interest: A.P. Abernethy has nothing to disclose.
Conflict of interest: M. Agar has nothing to disclose.
Support statement: This study was supported by the Australian Government Commonwealth Department of Health thought the National Palliative Care Program and National Health and Medical Research Council project grant GNT1010065, and sponsored by Flinders University. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received May 24, 2018.
- Accepted October 3, 2018.
- Copyright ©ERS 2019