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Meta-Analysis
. 2022 Dec;42(12):1654-1661.
doi: 10.1038/s41372-022-01500-8. Epub 2022 Aug 25.

Dual medication therapy (acetaminophen and ibuprofen) for the management of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis

Sanket D Shah  1 , Kartikeya Makker  2 , Mingyu Zhang  3 , Susan Harnett  4 , Khyzer B Aziz  2 , Mark L Hudak  5
Affiliations
Meta-Analysis

Dual medication therapy (acetaminophen and ibuprofen) for the management of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis

Sanket D Shah et al. J Perinatol. 2022 Dec.

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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