OBJECTIVE: To compare effectiveness of 3 surfactant preparations (beractant, calfactant, and poractant alfa) in premature infants for preventing 3 outcomes: (1) air leak syndromes; (2) death; and (3) bronchopulmonary dysplasia (BPD) or death (composite outcome). STUDY DESIGN: We conducted a comparative effectiveness study of premature infants admitted to 322 neonatal intensive care units in the US from 2005-2010 who were treated with beractant, calfactant, or poractant alfa. We compared the incidence of air leak syndromes, death, and BPD or death, adjusting for gestational age (GA), antenatal steroids, discharge year, and small for GA status. RESULTS: A total of 51282 infants received surfactant; 40% received beractant, 30% calfactant, and 30% poractant alfa. Median birth weight was 1435 g (IQR 966-2065); median GA was 30 weeks (27-33). On adjusted analysis, we observed a similar risk of air leak syndromes (calfactant vs beractant OR = 1.17 [95% CI: 0.95, 1.43]; calfactant vs poractant OR = 1.23 [0.98, 1.56]; beractant vs poractant OR = 1.06 [0.87, 1.29]), death (calfactant vs beractant OR = 1.14 [0.93, 1.39]; calfactant vs poractant OR = 0.98 [0.78, 1.23]; beractant vs poractant OR = 0.86 [0.72, 1.04]), and BPD or death (calfactant vs beractant OR = 1.08 [0.93, 1.26]; calfactant vs poractant OR = 1.19 [1.00, 1.41]; beractant vs poractant OR = 1.10 [0.96, 1.27]). CONCLUSIONS: Beractant, calfactant, and poractant alfa demonstrated similar effectiveness in prevention of air leak syndromes, death, and BPD or death in premature infants when adjusted for site. Previously described differences in mortality between surfactants likely do not represent true differences in effectiveness but may relate to site variation in outcomes.
OBJECTIVE: To compare effectiveness of 3 surfactant preparations (beractant, calfactant, and poractant alfa) in premature infants for preventing 3 outcomes: (1) air leak syndromes; (2) death; and (3) bronchopulmonary dysplasia (BPD) or death (composite outcome). STUDY DESIGN: We conducted a comparative effectiveness study of premature infants admitted to 322 neonatal intensive care units in the US from 2005-2010 who were treated with beractant, calfactant, or poractant alfa. We compared the incidence of air leak syndromes, death, and BPD or death, adjusting for gestational age (GA), antenatal steroids, discharge year, and small for GA status. RESULTS: A total of 51282 infants received surfactant; 40% received beractant, 30% calfactant, and 30% poractant alfa. Median birth weight was 1435 g (IQR 966-2065); median GA was 30 weeks (27-33). On adjusted analysis, we observed a similar risk of air leak syndromes (calfactant vs beractant OR = 1.17 [95% CI: 0.95, 1.43]; calfactant vs poractant OR = 1.23 [0.98, 1.56]; beractant vs poractant OR = 1.06 [0.87, 1.29]), death (calfactant vs beractant OR = 1.14 [0.93, 1.39]; calfactant vs poractant OR = 0.98 [0.78, 1.23]; beractant vs poractant OR = 0.86 [0.72, 1.04]), and BPD or death (calfactant vs beractant OR = 1.08 [0.93, 1.26]; calfactant vs poractant OR = 1.19 [1.00, 1.41]; beractant vs poractant OR = 1.10 [0.96, 1.27]). CONCLUSIONS: Beractant, calfactant, and poractant alfa demonstrated similar effectiveness in prevention of air leak syndromes, death, and BPD or death in premature infants when adjusted for site. Previously described differences in mortality between surfactants likely do not represent true differences in effectiveness but may relate to site variation in outcomes.
Authors: B T Bloom; J Kattwinkel; R T Hall; P M Delmore; E A Egan; J R Trout; M H Malloy; D R Brown; I R Holzman; C H Coghill; W A Carlo; A K Pramanik; M A McCaffree; P L Toubas; S Laudert; L L Gratny; K B Weatherstone; J H Seguin; L D Willett; G R Gutcher; D H Mueller; W H Topper Journal: Pediatrics Date: 1997-07 Impact factor: 7.124
Authors: M L Hudak; D J Martin; E A Egan; E J Matteson; N J Cummings; A L Jung; L V Kimberlin; R L Auten; A A Rosenberg; J M Asselin; M R Belcastro; P K Donohue; C R Hamm; R D Jansen; A S Brody; M M Riddlesberger; P Montgomery Journal: Pediatrics Date: 1997-07 Impact factor: 7.124
Authors: J W Kendig; R H Notter; C Cox; L J Reubens; J M Davis; W M Maniscalco; R A Sinkin; A Bartoletti; H S Dweck; M J Horgan Journal: N Engl J Med Date: 1991-03-28 Impact factor: 91.245
Authors: J D Horbar; R F Soll; H Schachinger; G Kewitz; H T Versmold; W Lindner; G Duc; D Mieth; O Linderkamp; E P Zilow Journal: Eur J Pediatr Date: 1990-03 Impact factor: 3.183
Authors: Jeffrey D Horbar; Gary J Badger; Joseph H Carpenter; Avroy A Fanaroff; Sarah Kilpatrick; Meena LaCorte; Roderic Phibbs; Roger F Soll Journal: Pediatrics Date: 2002-07 Impact factor: 7.124
Authors: C P Speer; O Gefeller; P Groneck; E Laufkötter; C Roll; L Hanssler; K Harms; E Herting; H Boenisch; J Windeler Journal: Arch Dis Child Fetal Neonatal Ed Date: 1995-01 Impact factor: 5.747
Authors: Kevin R Ellsworth; Marc A Ellsworth; Amy L Weaver; Kristin C Mara; Reese H Clark; William A Carey Journal: JAMA Pediatr Date: 2018-07-02 Impact factor: 16.193
Authors: Christoph P Hornik; Andrew M Atz; Catherine Bendel; Francis Chan; Kevin Downes; Robert Grundmeier; Ben Fogel; Debbie Gipson; Matthew Laughon; Michael Miller; Michael Smith; Chad Livingston; Cindy Kluchar; Anne Heath; Chanda Jarrett; Brian McKerlie; Hetalkumar Patel; Christina Hunter Journal: Appl Clin Inform Date: 2019-05-08 Impact factor: 2.342
Authors: Elizabeth J Thompson; Daniel K Benjamin; Rachel G Greenberg; Karan R Kumar; Kanecia O Zimmerman; Matthew Laughon; Reese H Clark; P Brian Smith; Christoph P Hornik Journal: Neonatology Date: 2020-10-07 Impact factor: 4.035
Authors: Kristin E D Weimer; Matthew S Kelly; Sallie R Permar; Reese H Clark; Rachel G Greenberg Journal: JAMA Pediatr Date: 2020-02-01 Impact factor: 16.193
Authors: Mihai Puia-Dumitrescu; Olivia M Bretzius; Nia Brown; James A Fitz-Henley; Rebecca Ssengonzi; Caroline S Wechsler; Keyaria D Gray; Daniel K Benjamin; P Brian Smith; Reese H Clark; Daniel Gonzalez; Christoph P Hornik Journal: J Pediatr Date: 2018-09-21 Impact factor: 4.406
Authors: Wesley Jackson; Genevieve Taylor; Nicolas A Bamat; Kanecia Zimmerman; Reese Clark; Daniel K Benjamin; Matthew M Laughon; Rachel G Greenberg; Christoph P Hornik Journal: J Perinatol Date: 2020-02-20 Impact factor: 2.521