A Meta-analysis of Ibuprofen Versus Indomethacin for Closure of Patent Ductus Arteriosus

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2005 Feb 18

PMID 15717178

Citations 31

Authors

Ronald L Thomas

Graham C Parker

Bart van Overmeire

Jacob V Aranda

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Ibuprofen (IBU) has previously been shown to be as effective as indomethacin (INDO) in closing the patent ductus arteriosus (PDA) of preterm infants, without severely affecting renal hemodynamics or basal cerebral blood flow. We conducted a meta-analysis of randomized trials to compare the efficacy and safety of IBU and INDO for treatment of PDA. Data from the nine relevant trials ( n =566), showed no significant difference in the efficacy of IBU and INDO in PDA closure ( P =0.70). However, five trials ( n =443) provided serum creatinine concentration data that revealed a significantly lower increase favoring IBU ( P < 0.001), and urine output data that showed a significantly lower decrease favoring IBU ( P < 0.001). In two trials ( n =188) the proportion of infants who required postnatal oxygen therapy at 28 days (defined as chronic lung disease) was significantly higher with IBU (52/94; 55.3%) than with INDO (38/94; 40.4%, P < 0.05). No statistically significant differences were found in mortality, intraventricular hemorrhage, necrotizing enterocolitis, surgical ligation, sepsis, retinopathy of prematurity, periventricular leukomalacia, length of hospital stay, gastrointestinal bleeding, re-opening of PDA, back-up treatment, surfactant therapy, or days on a ventilator.

Conclusion: ibuprofen and indomethacin have similar efficacy in patent ductus arteriosus closure, but preterm infants treated with ibuprofen experience lower serum creatinine values, higher urine output, and less undesirable decreased organ blood flow and vasoconstrictive adverse effects.

Citing Articles

Comparison of the Effectiveness of Paracetamol and Ibuprofen in the Management of Patent Ductus Arteriosus in Preterm Neonates: A Randomized Controlled Trial.

Shah S, Khan S, Sadiq F, Gul R, Sadiq F, Khan M Mol Cell Pediatr. 2025; 12(1):2.

PMID: 39862321 PMC: 11762024. DOI: 10.1186/s40348-025-00189-x.

A comparison of different dosing regimen of intravenous paracetamol for hemodynamically significant patent ductus arteriosus closure in premature neonates <32 weeks: a prospective observational study.

Goyal N, Haribalakrishna A, Krishnamurthy B J Perinatol. 2024; 44(10):1463-1469.

PMID: 38622217 DOI: 10.1038/s41372-024-01966-8.

Clinical Dilemma Involving Treatments for Very Low-Birth-Weight Infants and the Potential Risk of Necrotizing Enterocolitis: A Narrative Literature Review.

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Acute resveratrol exposure does not impact hemodynamics of the fetal sheep.

Darby J, Williams G, Cho S, Meakin A, Holman S, Quinn M Physiol Rep. 2023; 11(12):e15749.

PMID: 37332034 PMC: 10277215. DOI: 10.14814/phy2.15749.

Platelet Count and Volume and Pharmacological Closure with Paracetamol of Ductus Arteriosus in Preterm Infants.

Dani C, Ciarcia M, Miselli F, Luzzati M, Coviello C, Paladini A Children (Basel). 2022; 9(1).

PMID: 35053714 PMC: 8774717. DOI: 10.3390/children9010089.

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