IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia.
Discipline of Palliative and Supportive Services, Flinders University, Adelaide, Australia.
Eur Respir J. 2019 Jan 17;53(1). doi: 10.1183/13993003.01270-2018. Print 2019 Jan.
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.
舍曲林能否为病因得到最佳治疗的晚期疾病患者的慢性呼吸困难提供症状缓解？223 名患有慢性呼吸困难（改良的医学研究理事会呼吸困难量表≥2）且病因得到最佳治疗的患者，按 1:1 的比例随机分为舍曲林 25-100mg（9 天内逐渐增加剂量）或安慰剂组，治疗 4 周。主要结局是在 100mm 视觉模拟量表上，当前呼吸困难强度改善≥15%的患者比例。在第 26-28 天，与安慰剂相比，接受舍曲林治疗的患者对当前呼吸困难的反应比例相似（OR 1.00，95%CI 0.71-1.40）和其他呼吸困难测量指标。在 4 周内，舍曲林组的生活质量改善的可能性高于安慰剂组（OR 0.21，95%CI 0.01-0.41；p=0.044）。在功能状态、焦虑和抑郁或生存率方面没有观察到差异。两组的不良事件发生率相似。在这个患者群体中，舍曲林在缓解慢性呼吸困难的症状方面似乎没有优于安慰剂的效果。
