Dual Medication Therapy (acetaminophen and Ibuprofen) for the Management of Patent Ductus Arteriosus in Preterm Infants: a Systematic Review and Meta-analysis

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2022 Aug 25

PMID 36008521

Authors

Sanket D Shah

Kartikeya Makker

Mingyu Zhang

Susan Harnett

Khyzer B Aziz

Mark L Hudak

Affiliations

Soon will be listed here.

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.

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