The purpose of this pilot trial is to study efficacy and safety of simultaneous intravenous (iv) ibuprofen/indomethacin and paracetamol medications in the closure of patent ductus arteriosus (PDA) in preterm infants. It is randomized, placebo-controlled, double-blind, phase 1, multicenter, clinical trial.
Premature infants (born before 37 weeks gestational age) with patent ductus arteriosus (PDA) are the focus of the study since no trials on the additive efficacy of these two medications on the contraction of ductus arteriosus are available. Preterm infants who are diagnosed to have a hemodynamically significant PDA and who, according to the decision of the attending clinician, need ibuprofen/indomethacin therapy, are eligible to this trial. If the parents deny the consent, the patient will be treated according to the standard PDA treatment: three days' iv ibuprofen Pedea® 5mg/ml solution infusion (Oulu, Helsinki, Tartu) dosing: 10mg/kg + 5mg/kg + 5mg/kg (q24h); or three days' iv indomethacin (Turku) 0.2mg/kg + 0.1mg/kg + 0.1mg/kg (q24h). In case of any contraindications for ibuprofen/indomethacin, the treatment would be surgical ligation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
22
Helsinki Univeristy Central Hospital
Helsinki, Finland
Department of Pediatrics, Oulu University Hospital
Oulu, Finland
Tampere University Hospital
Tampere, Finland
Turku University Hospital
Turku, Finland
Ductal closure
Number of patients with ductal contraction without need for other PDA therapies
Time frame: Neonatal internsive care unit (NICU) stay up to 12 weeks
Need for ductal therapies
Given ductal therapies after the study drug
Time frame: NICU stay up to 12 weeks
Cardiac ultrasound findings
Ductal caliber (mm, mm/kg), LA/Ao ratio
Time frame: NICU stay up to 12 weeks
Duration of any ventilation assist
The ventilation assist time pediod
Time frame: NICU stay up to 12 weeks
Paracetamol serum levels
Measured paracetamol concentrations (mg/mL)
Time frame: Study drug period up to 4 days
Paracetamol side effects
Observed adverse events linked to study drug
Time frame: Study drug period plus 7 days, up to 10 days
Long term complications of prematurity
Moderate-to-severe bronchopulmonary dysplasia, intraventricular hemorrhage grade 2-4, moderate to severe necrotizing enterocolitis, retinopathy of prematurity needing therapy
Time frame: Hospital stay up to 18 weeks
Other long-term morbidity, and mortality
Other severe diseases
Time frame: Hospital stay up to 18 weeks
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Standard therapy