Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters (AMPLE-2): an open-label randomised trial

Publication date: Available online 20 July 2018Source: The Lancet Respiratory MedicineAuthor(s): Sanjeevan Muruganandan, Maree Azzopardi, Deirdre B Fitzgerald, Ranjan Shrestha, Benjamin C H Kwan, David C L Lam, Christian C De Chaneet, Muhammad Redzwan S Rashid Ali, Elaine Yap, Claire L Tobin, Luke A Garske, Phan T Nguyen, Christopher Stanley, Natalia D Popowicz, Christopher Kosky, Rajesh Thomas, Catherine A Read, Charley A Budgeon, David Feller-Kopman, Nick A MaskellSummaryBackgroundIndwelling pleural catheters are an established management option for malignant pleural effusion and have advantages over talc slurry pleurodesis. The optimal regimen of drainage after indwelling pleural catheter insertion is debated and ranges from aggressive (daily) drainage to drainage only when symptomatic.MethodsAMPLE-2 was an open-label randomised trial involving 11 centres in Australia, New Zealand, Hong Kong, and Malaysia. Patients with symptomatic malignant pleural effusions were randomly assigned (1:1) to the aggressive (daily) or symptom-guided drainage groups for 60 days and minimised by cancer type (mesothelioma vs others), performance status (Eastern Cooperative Oncology Group [ECOG] score 0–1 vs ≥2), presence of trapped lung, and prior pleurodesis. Patients were followed up for 6 months. The primary outcome was mean daily breathlessness score, measured by use of a 100 mm visual analogue scale during the first 60 days. Secondary outcomes included rates of spontaneous pleurodesis ...
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research