Bhatnagar R, et al. - Researchers inspected the effectiveness of talc administered through an indwelling pleural catheter at inducing pleurodesis compared to the use of an indwelling pleural catheter alone in patients with malignant pleural effusion at 18 centers in the United Kingdom. Findings disclosed a markedly higher chance of pleurodesis at 35 days among patients without substantial lung entrapment, through the outpatient administration of talc through an indwelling pleural catheter for the treatment of malignant pleural effusion, in contrast with an indwelling catheter alone, not displaying any deleterious effects.

Methods

• Patients with malignant pleural effusion were enrolled over a period of 4 years at 18 centers in the United Kingdom.
• They underwent drainage regularly on an outpatient basis following the insertion of an indwelling pleural catheter.
• In the absence of evidence of substantial lung entrapment (nonexpandable lung, in which lung expansion and pleural apposition are not possible because of visceral fibrosis or bronchial obstruction) at 10 days, subjects were randomly allocated to receive either 4 g of talc slurry or placebo through the indwelling pleural catheter on an outpatient basis.
• Based on a single-blind basis, talc or placebo was administered.
• The duration of follow-up was for 70 days.
• Successful pleurodesis at day 35 after randomization served as the primary outcome.

Results

• A total of 154 patients underwent randomization after 584 patients were approached.
• It was noted that 30 of 69 patients (43%) in the talc group presented with successful pleurodesis, as compared with 16 of 70 (23%) in the placebo group (hazard ratio, 2.20; 95% confidence interval, 1.23 to 3.92; P=0.008) at day 35.
• Findings did not unveil any notable between-group differences in effusion size and complexity, number of inpatient days, mortality, or number of adverse events.
• In the talc group, there were no prominent excess of blockages of the indwelling pleural catheter.