Table 1

Ibuprofen versus indomethacin in the treatment of patent ductus arteriosus (PDA)

CitationStudy groupStudy type (level of evidence)OutcomeKey resultsComments
Lago et al (2002) 175 preterm neonates, GA⩽34 wk, postnatal age 48–72 h with echo proven PDA. Very ill babies excluded. IBU (10 mg/kg iv [time 0], 5 mg/kg iv [time 24,48 h]) v INDO (0.2 mg/kg iv q12 h×3)RCT (level 1b) Jadad score: 2Echo proven closure of PDA.IBU = INDO for closure of PDA: ARR = 0.043 [95% CI −0.092 to 0.177]Only echocardiographers were noted to be blinded. Randomisation method not given. Allocation concealment by sealed envelope.
OliguriaINDO more likely to produce oliguria: p = 0.017, NNH = 7
Post-treatment serum creatinine.INDO resulted in higher post-treatment creatinine (mean 89 μmol/l, SD 24) than IBU (mean 81 μmol/l, SD 20): p = 0.03.
Van Overmeire et al (2000) 148 preterm neonates, GA⩽32 wk, postnatal age 48–96 h with echo proven PDA. Very ill babies excluded. IBU (3 doses) v INDO (3 doses), same doses as above.RCT (level 1b) Jadad score: 2Echo proven closure of PDAIBU = INDO for closure of PDA: ARR = 0.041 [95% CI −0.109 to 0.19].Only echocardiographers were noted to be blinded. Randomisation method not given. Allocation concealment by sealed opaque envelope.
OliguriaINDO more likely to produce oliguria: p = 0.03, NNH = 8
Post-treatment serum creatinineINDO resulted in higher post-treatment creatinine: p = 0.04.
Multiple logistic regression performed to determine predictors of oliguriaIndependent predictors of oliguria were INDO treatment, high frequency ventilation, increased serum creatinine days 1–3, and lower ductul shunt velocity.
Van Overmeire et al (1997) 40 preterm neonates, GA⩽33 wk, postnatal age 48–72 h with echo proven PDA. Very ill babies excluded. IBU (3 doses) v INDO (3 doses), same doses as above.RCT (level 1b) Jadad score: 2Echo proven closure of PDAIBU = INDO for closure of PDA: ARR 0.05 [95% CI −0.208 to 0.308]Randomisation method not given. Allocation concealment by sealed envelope. No blinding reported.
OliguriaINDO more likely to produce oliguria: p = 0.02, NNH = 3.
Post-treatment serum creatinineIBU = INDO for post-treatment serum creatinine: p = 0.07
Supapannachart et al (2002) 18 preterm infants (mean GA 30 weeks) with PDA based on clinical and x ray criteria. Very ill babies excluded. IBU (10 mg/kg po od × 3 days) v INDO (0.2 mg/kg po/iv q12 h × 3 doses)RCT (level 3b) Jadad score: 2Clinical closure of PDAIBU = INDO for closure of PDA: ARR 0.111 [95% CI −0.229 to 0.452]Randomisation method not given. Allocation concealment by sealed envelope. No blinding reported. INDO group was mixed between babies receiving oral and intravenous treatment; no attempt at subset analysis.
OliguriaNo significant difference after day 1.
Post-treatment serum creatinineNo significant difference.