Indomethacin effective for closing symptomatic PDA in preterm infants: Cochrane Review

Canada: Indomethacin may be effective in closing a symptomatic PDA in preterm infants as compared to placebo or no treatment, according to a recent Cochrane review. However, according to the authors, evidence is insufficient regarding indomethacin effects on medication-related adverse effects and clinically relevant outcomes.
Symptomatic patent ductus arteriosus (PDA) increases risk of morbidity and mortality in preterm infants. The use of indomethacin, a non-selective cyclooxygenase inhibitor, has shown short-term clinical benefits in these infants. However, the effect of indomethacin in preterm infants with a symptomatic PDA is still not explored. Souvik Mitra, Dalhousie University & IWK Health Centre, Halifax, Canada, and colleagues aimed to determine the safety and efficacy of indomethacin versus placebo or no treatment in reducing mortality and morbidity in preterm infants with a symptomatic PDA.
For the purpose, the researchers used the standard search strategy of Cochrane Neonatal to search for Cochrane Central Register of Controlled Trials on 31 July 2020. Clinical trials databases and reference lists of retrieved articles were searched for randomized controlled trials (RCTs) and quasi‐RCTs.
It included RCTs and quasi‐RCTs that compared indomethacin (any dose, any route) versus placebo or no treatment in preterm infants. A total of 14 RCTs consisting of 880 preterm infants were included.
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