Oral Ibuprofen versus Intravenous Ibuprofen or Intravenous Indomethacin for the Treatment of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis

@article{Neumann2012OralIV,
  title={Oral Ibuprofen versus Intravenous Ibuprofen or Intravenous Indomethacin for the Treatment of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis},
  author={Roland P. Neumann and Sven M. Schulzke and Christoph B{\"u}hrer},
  journal={Neonatology},
  year={2012},
  volume={102},
  pages={9 - 15}
}
Background: Pharmacological closure of patent ductus arteriosus (PDA) is commonly achieved by intravenous (IV) administration of ibuprofen or indomethacin. Occasionally, oral ibuprofen is used for PDA treatment although its efficacy and safety are unclear. Objectives: To systematically review randomized and quasi-randomized trials comparing oral ibuprofen with IV ibuprofen or IV indomethacin for closure of PDA in preterm infants. Methods: The standard search methods of the Cochrane Neonatal… 

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The aim of this review was to determine the efficacy and safety of ibuprofen for closing a PDA in preterm and/or low birth weight infants and to reduce the risk of developing necrotising enterocolitis.
Meta-Analysis to Assess Efficacy and Safety of High-Dose Ibuprofen Compared with Standard Treatment of Patent Ductus Arteriosus in Premature Infants
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Oral ibuprofen is as efficacious as intravenous indomethacin with similar adverse effects in preterm infants with PDA, and there were no significant differences in the mortality and late complications.
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TLDR
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Comparison of Oral Paracetamol with Oral Ibuprofen in Closing Patent Ductus Arteriosus in Premature Neonates: A Randomized Controlled Trial
TLDR
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Oral ibuprofen is superior to oral paracetamol for patent ductus arteriosus in very low and extremely low birth weight infants
TLDR
It is demonstrated that paracetamol may be a poor medical alternative for PDA management in VLBW and ELBW infants and subgroup analyses indicated par acetamol was minimally effective in EL BW infants.
Clinical pharmacology of ibuprofen in preterm infants: A meta-analysis of published data
TLDR
Oral ibuprofen has fewer renal adverse effects than intravenous ib uprofen and has the most favourable risk/benefit ratio.
Comparative evaluation for the use of oral ibuprofen and intravenous indomethacin in Korean infants with patent ductus
TLDR
Oral ibuprofen was as effective as intravenous indomethacin in the immature groups and more effective in the mature groups of neonates treated for PDA.
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References

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TLDR
The aim of this review was to determine the efficacy and safety of ibuprofen for closing a PDA in preterm and/or low birth weight infants and to reduce the risk of developing necrotising enterocolitis.
Oral ibuprofen and indomethacin for treatment of patent ductus arteriosus in premature infants: a randomized trial at Ramathibodi Hospital.
TLDR
Oral ibuprofen therapy is as effective as indomethacin for the treatment of PDA in premature infants and seems to have fewer renal side effects.
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TLDR
It is suggested that oral ibuprofen could be a valid alternative to indomethacin for the treatment of PDA in premature infants < 34 weeks and was associated with less side effects.
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TLDR
In very low birth weight infants, the rate of early ductal closure with oral ibuprofen is at least as good as with the intravenous route, and ductal closure may be obtained with an incomplete course of ib uprofen.
A comparison of oral ibuprofen and intravenous indomethacin for closure of patent ductus arteriosus in preterm infants.
TLDR
Ibuprofen has the same efficiency as indomethacin for the treatment of symptomatic patent ductus arteriosus in preterm infants and less likely to induce necrotizing enterocolitis and renal toxicity than indometHacin.
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TLDR
Oral ibuprofen is as effective as oral indomethacin for the treatment of PDA in preterm infants and is associated with a lower incidence of NEC.
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TLDR
Oral ibUprofen is as effective as intravenous ibuprofen for PDA closure even in ELBW preterm infants, and the need for postnatal steroid use for chronic lung disease was significantly lower in oral ib uprofen group than in intravenous group.
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TLDR
There were no statistically significant differences in mortality, surgical duct ligation, duration of ventilator support, IVH, PVL, NEC, decreased urine output, retinopathy of prematurity, and weighted mean difference (WMD), all with 95% confidence intervals (CI).
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TLDR
Prophylactic use of ibuprofen decreased the incidence of PDA, decreased the need for rescue treatment with cyclo-oxygenase inhibitors and decreased theneed for surgical closure, and until long-term follow-up results are published from the trials included in this updated review, no further trials of prophylaxis ibup rofen are recommended.
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