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BETTER TREATMENTS FOR BREATHLESSNESS IN PALLIATIVE AND END OF LIFE CARE

BETTER TREATMENTS FOR BREATHLESSNESS IN PALLIATIVE AND END OF LIFE CARE

Objective

The BETTER-B consortium tests whether mirtazapine, currently used as an antidepressant, is an effective treatment to reduce chronic or refractory breathlessness (CB) in patients with advanced chronic obstructive pulmonary or interstitial lung disease (COPD or ILD) needing palliative care or at the end of life.

Our focus is on breathlessness that persists despite optimal treatment of the underlying condition. This widespread and frightening symptom has a major detrimental impact on patients’ quality of life and distresses their family, friends and carers. It is associated with physical and psychosocial morbidity and results in high use of health care services, including emergency care.

There are no licenced medicines for CB in the world. It is a major challenge to clinical management, care quality and patient wellbeing. We have completed a feasibility trial in 60 patients, reviews and case studies that suggest mirtazapine is a promising treatment.

To assess if mirtazapine is effective, we conduct a randomised double blind clinical trial of mirtazapine versus placebo in patients with CB and COPD or ILD. The trial recruits 324 patients over 18 months across respiratory, palliative care and community services in Poland, Ireland, Italy, Germany and the UK. We study the effects of treatment over time on patients, their family or caregivers and care costs. We survey clinicians and produce accessible European guidance on treating CB.

The consortium unites a unique multi-disciplinary group of clinician scientists from respiratory, palliative, geriatric and rehabilitation fields, alongside statisticians, trialists, health economists, health care researchers, patient and consumer groups and a European Society. This ensures the optimal design and operation of the trial and the widest impact from its results.

Using an existing medicine for a different purpose offers a highly cost-effective approach for treatment that can be implemented and sustained internationally.

Coordinator

KING'S COLLEGE LONDON

Address

Strand
Wc2r 2ls London

United Kingdom

Activity type

Higher or Secondary Education Establishments

EU Contribution

€ 1 395 122,75

Participants (12)

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UNIVERSITY COLLEGE DUBLIN, NATIONAL UNIVERSITY OF IRELAND, DUBLIN

Ireland

EU Contribution

€ 476 203,75

AZIENDA UNITA SANITARIA LOCALE DI REGGIO EMILIA

Italy

EU Contribution

€ 283 960

UNIWERSYTET MIKOLAJA KOPERNIKA W TORUNIU

Poland

EU Contribution

€ 76 290

KLINIKUM DER UNIVERSITAET ZU KOELN

Germany

EU Contribution

€ 170 383,25

GDANSKI UNIWERSYTET MEDYCZNY

Poland

EU Contribution

€ 97 612,50

UNIVERSITA CATTOLICA DEL SACRO CUORE

Italy

EU Contribution

€ 88 987,50

LUDWIG-MAXIMILIANS-UNIVERSITAET MUENCHEN

Germany

EU Contribution

€ 230 812,50

THE UNIVERSITY OF NOTTINGHAM

United Kingdom

EU Contribution

€ 106 095

UNIVERSITY OF LEEDS

United Kingdom

EU Contribution

€ 669 111,25

UNIVERSITY OF TECHNOLOGY SYDNEY

Australia

THE PROVOST, FELLOWS, FOUNDATION SCHOLARS & THE OTHER MEMBERS OF BOARD OF THE COLLEGE OF THE HOLY & UNDIVIDED TRINITY OF QUEEN ELIZABETH NEAR DUBLIN

Ireland

EU Contribution

€ 109 671,25

EUROPEAN RESPIRATORY SOCIETY

Switzerland

EU Contribution

€ 65 750

Project information

Grant agreement ID: 825319

Status

Ongoing project

  • Start date

    1 January 2019

  • End date

    31 December 2022

Funded under:

H2020-EU.3.1.3.

  • Overall budget:

    € 3 791 503,50

  • EU contribution

    € 3 769 999,75

Coordinated by:

KING'S COLLEGE LONDON

United Kingdom