Combination pharmacotherapy for patent ductus arteriosus: Rationale and evidence.
Combination pharmacotherapy for patent ductus arteriosus: Rationale and evidence.
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DOI：
10.1016/j.semperi.2023.151720
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发表时间：
2023-03
影响因子：
3.4
通讯作者：
Jain, Amish
中科院分区：
文献类型：
--
作者：
Jasani, Bonny;Weisz, Dany E.;Reese, Jeff;Jain, Amish
虽然环氧合酶抑制剂是用于促进早产儿动脉导管未闭早期闭合的最常见药物，但极低胎龄新生儿（ELGAN）的不良反应和低疗效突出了对替代选择的需求。对乙酰氨基酚和布洛芬的联合治疗是ELGAN中PDA治疗的一种新策略，因为它可以通过对抑制前列腺素产生的两种单独途径的叠加作用促进更高的导管闭合率。最初的小型观察性研究和初步随机临床试验表明，与布洛芬单独治疗相比，联合方案诱导导管闭合的有效性可能更高。在这篇综述中，我们研究了治疗失败的潜在临床影响，在ELGAN与显着的PDA，强调支持研究联合治疗的生物学原理，并审查随机和非随机研究的日期。随着越来越多的ELGAN接受新生儿重症监护，谁是容易受到PDA相关的发病率，迫切需要有足够的动力临床试验，系统地研究PDA治疗的联合治疗的疗效和安全性。
While cyclooxygenase inhibitors have been the most common medications used to facilitate earlier closure of patent ductus arteriosus in preterm infants, adverse effects and low efficacy in extremely low gestational age neonates (ELGANs) have highlighted a need for alternative options. Combination therapy with acetaminophen and ibuprofen is a novel strategy for PDA treatment in ELGANs, as it may facilitate higher ductal closure rates via additive action on two separate pathways inhibiting prostaglandin production. Initial small observational studies and pilot randomized clinical trials indicate potentially higher efficacy of the combination regime to induce ductal closure in comparison to treatment with ibuprofen alone. In this review, we examine the potential clinical impact of treatment failure in ELGANs with significant PDA, highlight the biological rationale in support of studying combination therapy, and review the randomized and non-randomized studies to date. With the rising number of ELGANs receiving neonatal intensive care, who are vulnerable to PDA-related morbidities, there is an urgent need for adequately powered clinical trials to systematically investigate the efficacy and safety of combination therapy for PDA treatment.
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PDA-验证试验：一项探索性随机对照试验，是对1周大的中度至大型专利导管的治疗。
DOI：
10.1016/j.jpeds.2018.09.012
发表时间：
2019-03
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Clyman RI;Liebowitz M;Kaempf J;Erdeve O;Bulbul A;Håkansson S;Lindqvist J;Farooqi A;Katheria A;Sauberan J;Singh J;Nelson K;Wickremasinghe A;Dong L;Hassinger DC;Aucott SW;Hayashi M;Heuchan AM;Carey WA;Derrick M;Fernandez E;Sankar M;Leone T;Perez J;Serize A;PDA-TOLERATE (PDA: TO LEave it alone or Respond And Treat Early) Trial Investigators
通讯作者：
PDA-TOLERATE (PDA: TO LEave it alone or Respond And Treat Early) Trial Investigators
影响因子：
2.4
作者：
Adrouche-Amrani, Lynda;Green, Robert S.;Lin, Jing
通讯作者：
Lin, Jing
影响因子：
2.9
作者：
Bussmann, Neidin;Smith, Aisling;EL-Khuffash, Afif
通讯作者：
EL-Khuffash, Afif
影响因子：
2.7
作者：
Elmas, Ahmet Taner;Tabel, Yilmaz;Ozdemir, Ramazan
通讯作者：
Ozdemir, Ramazan
影响因子：
3.6
作者：
Chang, Ling Yi;McCurnin, Donald;Clyman, Ronald I.
通讯作者：
Clyman, Ronald I.