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Second Course of Therapy for Resistant Patent Ductus Arteriosus (PDA)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01070745
Recruitment Status : Withdrawn (Changes in approach to PDA therapy)
First Posted : February 18, 2010
Last Update Posted : June 7, 2012
Information provided by:
Shaare Zedek Medical Center

Brief Summary:

Patency of the ductus arteriosus (PDA) is functionally essential for fetal circulation, however persistence of ductal patency postnatally may have significant adverse hemodynamic effects in the neonate. Medical therapy for PDA predominantly involves the administration of one of two non-steroidal anti-inflammatory drugs: indomethacin or ibuprofen. Both of these therapies have been shown to be successful in mediating ductal closure in approximately 70% of treated infants.

However, the need for a second course of treatment for PDA closure remains quite common. The investigators hypothesize that, because of small differences between the two drugs, a greater percentage of infants who did not respond to a first course of therapy with indomethacin will respond to a second course with ibuprofen than to a repeat course of indomethacin.

As such, the investigators aim to compare secondary therapy with a repeat course of indomethacin to secondary therapy with ibuprofen in infants whose ductus remained patent after a first course of therapy with indomethacin.

Condition or disease Intervention/treatment Phase
Patent Ductus Arteriosus Drug: Indomethacin Drug: Ibuprofen Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Ibuprofen vs. Indomethacin as Second Course of Therapy for Resistant PDA in Low Birth Weight Neonates
Study Start Date : June 2010
Estimated Primary Completion Date : June 2012

Arm Intervention/treatment
Experimental: Indomethacin for resistant PDA
Treatment with second course of indomethacin
Drug: Indomethacin
Three doses of intravenous (IV) indomethacin at 0.2 mg/kg/dose given over 30 minutes, at intervals of 12 hours
Other Name: Indomed

Experimental: Ibuprofen for resistant PDA
Ibuprofen as second course of therapy
Drug: Ibuprofen
10 mg/kg infused over 30 minutes, followed by two doses of 5mg/kg each at 24 hour intervals
Other Name: Arfen

Primary Outcome Measures :
  1. Improvement in ductal closure rates in those infants who do not respond to a first course of therapy [ Time Frame: 2.5 years ]

Secondary Outcome Measures :
  1. More infants who did not respond to a first course of therapy with indomethacin who respond to a second course with ibuprofen than to a repeat course of indomethacin [ Time Frame: 2.5 years ]
  2. Secondary treatment with ibuprofen, as opposed to indomethacin, will not be associated with increased side effects [ Time Frame: 2.5 years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   up to 2 Months   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Inborn premature neonates (birth weight [BW] <1500 grams) being treated in the neonatal intensive care unit of the Shaare Zedek Medical Center and diagnosed as still having a hemodynamically significant patent ductus arteriosus (hsPDA) after a first course of therapy with indomethacin, will be considered as potential candidates for study pending response to initial therapy and pending parental consent.

Exclusion Criteria:

  • Any baby not considered viable
  • Any baby with intraventricular hemorrhage (IVH) grade 3-4 of recent onset (within 3 days). [If no head ultrasound has been performed within the last 3-4 days, one should be performed prior to onset of study.]
  • Any baby with dysmorphic features or congenital abnormalities
  • Any baby with structural heart disease other than PDA
  • Any baby with documented infection,
  • Any baby with thrombocytopenia (<50,000).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01070745

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Shaare Zedek Medical Center
Jerusalem, Israel, 91031
Sponsors and Collaborators
Shaare Zedek Medical Center
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Principal Investigator: Cathy Hammerman, MD Shaare Zedek Medical Investigator
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Responsible Party: Dr. Cathy Hammerman, Shaare Zedek Medical Center Identifier: NCT01070745    
Other Study ID Numbers: chammerman3
First Posted: February 18, 2010    Key Record Dates
Last Update Posted: June 7, 2012
Last Verified: February 2010
Keywords provided by Shaare Zedek Medical Center:
Additional relevant MeSH terms:
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Ductus Arteriosus, Patent
Heart Defects, Congenital
Cardiovascular Abnormalities
Cardiovascular Diseases
Heart Diseases
Congenital Abnormalities
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents
Antirheumatic Agents
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Gout Suppressants
Tocolytic Agents
Reproductive Control Agents