Paracetamol for the treatment of patent ductus arteriosus in preterm neonates: a systematic review and meta-analysis
| Autor: | Mustafa Doğan, Omer Erdeve, Cathy Hammerman, Rahul Sinha, Gianluca Terrin, Kadir Şerafettin Tekgündüz, Bonny Jasani, Irena Kessel, Francesca Conte, Sinno H.P. Simons, Francesco Manguso, Mehmet Yekta Oncel, Mario De Curtis, E Nadir, Sadık Yurttutan, Patrick J. McNamara, Serdar Alan, A. Scipione |
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| Přispěvatelé: | Pediatrics, Hitit Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü |
| Rok vydání: | 2016 |
| Předmět: |
Pediatrics
drug safety paracetamol data analysis Acetaminophen/*therapeutic use Cyclooxygenase Inhibitors/*therapeutic use Ductus Arteriosus Patent/*drug therapy Humans Ibuprofen/therapeutic use Infant Newborn Infant Premature Ibuprofen Medical Subject Headings 0302 clinical medicine aspartate aminotransferase systematic review newborn Ductus arteriosus therapeutics Scopus 030212 general & internal medicine randomized controlled trial (topic) Ductus Arteriosus Patent intensive care [Belirlenecek] Medline Obstetrics and Gynecology clinical trial (topic) indometacin General Medicine risk benefit analysis cardiology neonatology acetaminophen cyclooxygenase inhibitors ductus arteriosus patent humans ibuprofen infant newborn infant premature pediatrics perinatology and child health obstetrics and gynecology medicine (all) patent medicine.anatomical_structure gamma glutamyltransferase priority journal risk factor Meta-analysis prostaglandin synthase inhibitor medicine.drug medicine.medical_specialty side effect pediatrics alanine aminotransferase MEDLINE Placebo Article premature patent ductus arteriosus 03 medical and health sciences 030225 pediatrics Intensive care medicine Cyclooxygenase Inhibitors human Neonatology Mantel Haenszel test Acetaminophen business.industry practice guideline organic chemicals prematurity infant data collection method drug efficacy ductus arteriosus confidence interval Pediatrics Perinatology and Child Health placebo perinatology and child health Web of Science aspartate aminotransferase blood level gamma glutamyl transferase blood level business alanine aminotransferase blood level meta analysis |
| Zdroj: | Archives of Disease in Childhood. Fetal and Neonatal Edition, 101(2), F127-F136. BMJ Publishing Group |
| ISSN: | 1359-2998 |
| DOI: | 10.1136/archdischild-2014-307312 |
| Popis: | Objectives We performed a systematic review and meta-analysis of all the available evidence to assess the efficacy and safety of paracetamol for the treatment of patent ductus arteriosus (PDA) in neonates, and to explore the effects of clinical variables on the risk of closure. Data source MEDLINE, Scopus and ISI Web of Knowledge databases, using the following medical subject headings and terms: paracetamol, acetaminophen and patent ductus arteriosus. Electronic and manual screening of conference abstracts from international meetings of relevant organisations. Manual search of the reference lists of all eligible articles. Study selection Studies comparing paracetamol versus ibuprofen, indomethacin, placebo or no intervention for the treatment of PDA. Data extraction Data regarding efficacy and safety were collected and analysed. Results Sixteen studies were included: 2 randomised controlled trials (RCTs) and 14 uncontrolled studies. Quality of selected studies is poor. A meta-analysis of RCTs does not demonstrate any difference in the risk of ductal closure (Mantel–Haenszel model, RR 1.07, 95% CI 0.87 to 1.33 and RR 1.03, 95% CI 0.92 to 1.16, after 3 and 6 days of treatment, respectively). Proportion meta-analysis of uncontrolled studies demonstrates a pooled ductal closure rate of 49% (95% CI 29% to 69%) and 76% (95% CI 61% to 88%) after 3 and 6 days of treatment with paracetamol, respectively. Safety profiles of paracetamol and ibuprofen are similar. Conclusions Efficacy and safety of paracetamol appear to be comparable with those of ibuprofen. These results should be interpreted with caution, taking into account the non-optimal quality of the studies analysed and the limited number of neonates treated with paracetamol so far. |
| Databáze: | OpenAIRE |
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