Led by the ARC’s palliative and end of life care researchers, and hosted over two days in December, the BETTER-B Conference brought together more than 200 researchers, people affected by breathlessness, policymakers and healthcare professionals to explore treatment options for refractory (or chronic) breathlessness.

A woman with breathing equipment

The conference centered on the Better Treatments for Refractory Breathlessness (BETTER-B) research programme, which aims to significantly improve the treatment of severe breathlessness in patients with advanced respiratory disease by establishing whether mirtazapine, currently used as an antidepressant, is an effective treatment to reduce severe breathlessness even when people are not depressed. The BETTER-B programme started in 2019 and is finishing in December 2023.

Chronic breathlessness is a distressing and common symptom of advanced chronic respiratory diseases, often leading to social isolation, high healthcare costs and poor prognosis. Currently, there are few effective drug treatments. Our programme represents a crucial effort to expand treatment options for this distressing symptom.

Professor Irene Higginson

Professor Irene Higginson, BETTER-B's chief investigator, Cicely Saunders Institute, King's College London

Over two days, conference presenters explored interventions for alleviating breathlessness and results from the study. On the first day (4 December 2023), speakers included: 

  • Professor Matthew Maddocks who provided an overview of the BETTER-B programme
  • Professor Bobbie Farsides, chair of the Ethics Advisory Board, who spoke about the ethical aspects of carrying out an international, multi-centre, randomised controlled trial of a drug for this condition
  • Dr Sabrina Bajwah, who discussed the use of benzodiazepines in breathlessness management

After this, Dr Claire Nolan presented evidence on meditative movement techniques for breathlessness in advanced Chronic Obstructive Pulmonary Disease (COPD) and cancer.

On the second day (11 December 2023), Professor Irene Higginson set out the context for the BETTER-B programme. Professor Malgorzata Krajnik then discussed the BETTER-B survey and presented its results, showing wide variations in how breathlessness is managed across services in Europe and internationally.

Dr Adejoke Oluyase, BETTER-B project manager, then spoke on the BETTER-B trial processes and delivery, highlighting that this is now the largest trial of mirtazapine for breathlessness globally.

Through engaging presentations and discussion, we explored treatment options for refractory breathlessness, a distressing symptom that affects individuals with various respiratory conditions, as well as the ethical aspects of carrying out this type of research

Adejoke Oluyase

Dr Adejoke Oluyase, BETTER-B project manager, Cicely Saunders Institute, King's College London

Find out more

Slides 4 December

Slides 11 December

For further information

Read more about the BETTER-B programme, visit www.betterbreathe.eu