Effect of an Indwelling Pleural Catheter vs Talc Pleurodesis on Hospitalization Days in Patients With Malignant Pleural Effusion: The AMPLE Randomized Clinical Trial.
Thomas R, Fysh ETH, Smith NA, Lee P, Kwan BCH, Yap E, Horwood FC, Piccolo F, Lam DCL, Garske LA, Shrestha R, Kosky C, Read CA, Murray K, Lee YCG.
JAMA. 2017 Nov 21;318(19):1903-1912
In Australia and Asia, 146 patients with Malignant Pleural Effusion were randomised to either talc pleurodesis or indwelling pleural catheter. Patients treated with talc pleurodesis spent a median of 12 days in hospital compared to patients with indwelling pleural catheter who spent 10 days (p=0.03) with a mean reduction of 3.6 days per patient in hospital. 22.5% of patients with pleurodesis required further pleural interventions compared to 4.1% of patients with indwelling pleural catheter (P=0.001). Breathlessness and quality of life scores improved in both groups after treatment with no significant differences between groups. Common adverse effects were procedure-related pain and worsening breathlessness which occurred in 30% in the indwelling pleural catheter group and 18% in the pleurodesis group. Although the differences are of uncertain clinical importance, they could help patients make a more informed decision treatment choice.
Composed by Elaine Boland.