Dual medication therapy (acetaminophen and ibuprofen) for the management of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis

Sanket D. Shah; Kartikeya Makker; Mingyu Zhang; Susan Harnett; Khyzer B. Aziz; Mark L. Hudak

doi:10.1038/s41372-022-01500-8

Dual medication therapy (acetaminophen and ibuprofen) for the management of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis

Sanket D. Shah
, Kartikeya Makker
, Mingyu Zhang
, Susan Harnett
, Khyzer B. Aziz
, Mark L. Hudak

Nemours Medical Library

University of Florida
Johns Hopkins University

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

OBJECTIVE: To examine the efficacy of dual medication therapy (intervention) (DMT: acetaminophen and ibuprofen) vs. single medication therapy (control) (SMT: ibuprofen) for medical management of PDA (outcomes) in preterm infants (population).

STUDY DESIGN: We systematically searched multiple sources to identify randomized controlled trials (RCT) and non-randomized studies (NRS) that compared DMT to SMT for management of hemodynamically significant PDA.

RESULTS: We identified two RCTs and four NRS. There were no differences in the rates of successful PDA closure following the first treatment course between DMT and SMT (RR = 1.23 [95% CI 0.89-1.70] for NRS and RR = 1.18 [95% CI 0.66-2.10] for RCTs), nor were there significant differences in secondary outcomes and adverse events including PDA ligation, bronchopulmonary dysplasia, and necrotizing enterocolitis etc. Markers of hepatic/renal function did not change significantly during treatment.

CONCLUSION: We found no evidence for superiority of DMT over SMT in PDA management.

Original language	English
Pages (from-to)	1654-1661
Number of pages	8
Journal	Journal of Perinatology
Volume	42
Issue number	12
DOIs	https://doi.org/10.1038/s41372-022-01500-8 https://doi.org/10.1038/s41372-022-01500-8
State	Published - Dec 2022

Keywords

Infant, Newborn
Humans
Ductus Arteriosus, Patent/drug therapy
Ibuprofen/therapeutic use
Acetaminophen
Indomethacin
Infant, Low Birth Weight
Infant, Premature

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Shah, S. D., Makker, K., Zhang, M., Harnett, S., Aziz, K. B., & Hudak, M. L. (2022). Dual medication therapy (acetaminophen and ibuprofen) for the management of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis. Journal of Perinatology, 42(12), 1654-1661. https://doi.org/10.1038/s41372-022-01500-8, https://doi.org/10.1038/s41372-022-01500-8

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title = "Dual medication therapy (acetaminophen and ibuprofen) for the management of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis",

abstract = "OBJECTIVE: To examine the efficacy of dual medication therapy (intervention) (DMT: acetaminophen and ibuprofen) vs. single medication therapy (control) (SMT: ibuprofen) for medical management of PDA (outcomes) in preterm infants (population).STUDY DESIGN: We systematically searched multiple sources to identify randomized controlled trials (RCT) and non-randomized studies (NRS) that compared DMT to SMT for management of hemodynamically significant PDA.RESULTS: We identified two RCTs and four NRS. There were no differences in the rates of successful PDA closure following the first treatment course between DMT and SMT (RR = 1.23 [95\% CI 0.89-1.70] for NRS and RR = 1.18 [95\% CI 0.66-2.10] for RCTs), nor were there significant differences in secondary outcomes and adverse events including PDA ligation, bronchopulmonary dysplasia, and necrotizing enterocolitis etc. Markers of hepatic/renal function did not change significantly during treatment.CONCLUSION: We found no evidence for superiority of DMT over SMT in PDA management.",

keywords = "Infant, Newborn, Humans, Ductus Arteriosus, Patent/drug therapy, Ibuprofen/therapeutic use, Acetaminophen, Indomethacin, Infant, Low Birth Weight, Infant, Premature",

author = "Shah, \{Sanket D.\} and Kartikeya Makker and Mingyu Zhang and Susan Harnett and Aziz, \{Khyzer B.\} and Hudak, \{Mark L.\}",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer Nature America, Inc.",

year = "2022",

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doi = "10.1038/s41372-022-01500-8",

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Shah, SD, Makker, K, Zhang, M, Harnett, S, Aziz, KB & Hudak, ML 2022, 'Dual medication therapy (acetaminophen and ibuprofen) for the management of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis', Journal of Perinatology, vol. 42, no. 12, pp. 1654-1661. https://doi.org/10.1038/s41372-022-01500-8, https://doi.org/10.1038/s41372-022-01500-8

TY - JOUR

T1 - Dual medication therapy (acetaminophen and ibuprofen) for the management of patent ductus arteriosus in preterm infants

T2 - a systematic review and meta-analysis

AU - Shah, Sanket D.

AU - Makker, Kartikeya

AU - Zhang, Mingyu

AU - Harnett, Susan

AU - Aziz, Khyzer B.

AU - Hudak, Mark L.

PY - 2022/12

Y1 - 2022/12

N2 - OBJECTIVE: To examine the efficacy of dual medication therapy (intervention) (DMT: acetaminophen and ibuprofen) vs. single medication therapy (control) (SMT: ibuprofen) for medical management of PDA (outcomes) in preterm infants (population).STUDY DESIGN: We systematically searched multiple sources to identify randomized controlled trials (RCT) and non-randomized studies (NRS) that compared DMT to SMT for management of hemodynamically significant PDA.RESULTS: We identified two RCTs and four NRS. There were no differences in the rates of successful PDA closure following the first treatment course between DMT and SMT (RR = 1.23 [95% CI 0.89-1.70] for NRS and RR = 1.18 [95% CI 0.66-2.10] for RCTs), nor were there significant differences in secondary outcomes and adverse events including PDA ligation, bronchopulmonary dysplasia, and necrotizing enterocolitis etc. Markers of hepatic/renal function did not change significantly during treatment.CONCLUSION: We found no evidence for superiority of DMT over SMT in PDA management.

AB - OBJECTIVE: To examine the efficacy of dual medication therapy (intervention) (DMT: acetaminophen and ibuprofen) vs. single medication therapy (control) (SMT: ibuprofen) for medical management of PDA (outcomes) in preterm infants (population).STUDY DESIGN: We systematically searched multiple sources to identify randomized controlled trials (RCT) and non-randomized studies (NRS) that compared DMT to SMT for management of hemodynamically significant PDA.RESULTS: We identified two RCTs and four NRS. There were no differences in the rates of successful PDA closure following the first treatment course between DMT and SMT (RR = 1.23 [95% CI 0.89-1.70] for NRS and RR = 1.18 [95% CI 0.66-2.10] for RCTs), nor were there significant differences in secondary outcomes and adverse events including PDA ligation, bronchopulmonary dysplasia, and necrotizing enterocolitis etc. Markers of hepatic/renal function did not change significantly during treatment.CONCLUSION: We found no evidence for superiority of DMT over SMT in PDA management.

KW - Infant, Newborn

KW - Humans

KW - Ductus Arteriosus, Patent/drug therapy

KW - Ibuprofen/therapeutic use

KW - Acetaminophen

KW - Indomethacin

KW - Infant, Low Birth Weight

KW - Infant, Premature

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DO - 10.1038/s41372-022-01500-8

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C2 - 36008521

AN - SCOPUS:85137045319

SN - 0743-8346

VL - 42

SP - 1654

EP - 1661

JO - Journal of Perinatology

JF - Journal of Perinatology

IS - 12

ER -

Dual medication therapy (acetaminophen and ibuprofen) for the management of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis

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