Extract
People with interstitial lung disease (ILD) often have persistent breathlessness that worsens over months or years, despite optimal disease modifying therapies and non-pharmacological interventions [1]. Regular, low-dose, systemic morphine is recommended as treatment for persistent breathlessness [2, 3], but the majority of participants in studies of this therapy have COPD as the most prevalent aetiology [4, 5]; evidence in ILD is scant. One parallel-arm randomised controlled trial in people with fibrotic ILD suggested that immediate-release oral morphine 5 mg every 6 h was ineffective for breathlessness reduction compared to placebo after 1 week; the direction of signal favoured morphine but not at statistically significant or clinically relevant levels. Morphine produced more harms [6].
Tweetable abstract
In this trial of low-dose, sustained-release morphine for breathlessness in ILD there was no clear signal of improvement; morphine was associated with more harms. Predictors of response and factors influencing perception of benefit need to be identified. https://bit.ly/45TM7Jf
Acknowledgements
The authors thank all of the people who gave their time and energy to participate in the study, and each site investigator team. The authors also thank Debbie Marriott for her ready assistance and for her expertise in article formatting and submission, and Aine Greene for her help with recruitment and data collection.
Footnotes
This study is registered at https://www.anzctr.org.au/ with registration number: ACTRN12611000711910. De-identified participant data collected for the trial are available on request. Research data requests should be submitted to the corresponding author for consideration by the research team.
Conflict of interest: D.C. Currow reports advisory board membership and consultancy for Helsinn Pharmaceuticals, is a consultant and receives payment for intellectual property with Mayne Pharma International Pty Ltd, is subcontractor to Nous Group Pty Ltd, is a board member for icare Dust Diseases Care NSW, and is a board member/director of NSW Health Pathology and the Chris O'Brien Lifehouse cancer centre. The remaining authors have no potential conflicts of interest to disclose.
Support statement: Funding for this study was generously provided by the Dust Diseases Board of NSW. Funders had no input to the design, conduct, analysis, interpretation or dissemination of the findings.
- Received April 26, 2023.
- Accepted August 20, 2023.
- Copyright ©The authors 2023. For reproduction rights and permissions contact permissions{at}ersnet.org
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