Talc Pleurodesis via Indwelling Pleural Catheter vs Standard Talc Pleurodesis for MPE (AMPLE)

AMPLE tested whether talc slurry instilled via IPC (outpatient) could achieve pleurodesis equivalent to standard talc pleurodesis via chest tube (inpatient).

Multicenter RCT (8 Australian/UK centers, n=154) comparing talc via IPC vs. talc via chest tube for MPE.

Pleurodesis success at 35 days was equivalent (43% IPC-talc vs 51% chest tube-talc, p=0.31). IPC-talc patients had shorter initial hospitalization (0 vs 3.5 days). No difference in dyspnea, adverse events, or quality of life.

Talc instilled via IPC achieves equivalent pleurodesis to standard chest tube talc pleurodesis, with the advantage of outpatient management. This supports IPC as the preferred first-line approach for MPE — pleurodesis can be attempted through the IPC without additional hospitalization.

Pleurodesis success rate was lower than expected in both arms. Short follow-up for a cancer population.