Abstract
Does sertraline provide symptomatic relief for chronic breathlessness in people with advanced disease whose underlying cause(s) are optimally treated?
Two hundred and twenty three participants with chronic breathlessness (modified Medical Research Council (mMRC) breathlessness scale ≥2) who had optimal treatment of underlying cause(s) were randomised 1:1 to sertraline 25 mg–100 mg (titrated upwards over nine days) or placebo for four 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 (VAS).
The proportion of people responding to sertraline was similar to placebo for current breathlessness on days 26–28 (odds ratio [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 placebo over the four weeks (OR 0·21, 95% CI 0·01–0·41, p=0·044). No differences in performance status, anxiety and depression, nor 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.
Footnotes
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Conflict of interest: Dr. Currow has nothing to disclose.
Conflict of interest: Ms. Louw reports personal fees from Palliative Care Clinical Studies Collaborative, during the conduct of the study.
Conflict of interest: Dr. Hill has nothing to disclose.
Conflict of interest: Dr. Fazekas has nothing to disclose.
Conflict of interest: Dr. Clark has nothing to disclose.
Conflict of interest: Dr. Davidson has nothing to disclose.
Conflict of interest: Dr. Sajkov has nothing to disclose.
Conflict of interest: Dr. McCaffrey has nothing to disclose.
Conflict of interest: Dr. Doogue has nothing to disclose.
Conflict of interest: Dr. Abernethy has nothing to disclose.
Conflict of interest: Dr. Agar has nothing to disclose.
Conflict of interest: Dr. Ekström has nothing to disclose.
Conflict of interest: Dr. McDonald reports personal fees from GSK, personal fees from Pfizer, other from Menarini, personal fees from Novartis, outside the submitted work.
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