Sydney R Rooney1, Elaine L Shelton2, Ida Aka2, Christian M Shaffer3, Ronald I Clyman4, John M Dagle5, Kelli Ryckman6, Tamorah R Lewis7, Jeff Reese2, Sara L Van Driest2,3, Prince J Kannankeril2. 1. Vanderbilt University School of Medicine, UCSF, Nashville, TN 37232, USA. 2. Department of Pediatrics, Vanderbilt University Medical Center, UCSF, Nashville, TN 37232, USA. 3. Department of Medicine, Vanderbilt University Medical Center, UCSF, Nashville, TN 37232, USA. 4. Department of Pediatrics & Cardiovascular Research Center, University of California San Francisco, San Francisco, CA 94143, USA. 5. Department of Pediatrics, University of Iowa, Iowa City, UMKC, IA 52242, USA. 6. Department of Epidemiology, University of Iowa, Iowa City, UMKC, IA 52242, USA. 7. Department of Pediatrics, University of Missouri Kansas City School of Medicine, Kansas City, MO 64110, USA.
Abstract
Aims: To identify clinical andgenetic factors associated with indomethacin treatment failure in preterm neonates with patent ductus arteriosus (PDA). Patients & Methods: This is a multicenter cohort study of 144 preterm infants (22-32 weeks gestational age) at three centers who received at least one treatment course of indomethacin for PDA. Indomethacin failure was defined as requiring subsequent surgical intervention. Results: In multivariate analysis, gestational age (AOR 0.76, 95% CI 0.60-0.96), surfactant use (AOR 9.77, 95% CI 1.15-83.26), and CYP2C9*2 (AOR 3.74; 95% CI 1.34-10.44) were each associated with indomethacin failure. Conclusion: Age, surfactant use, and CYP2C9*2 influence indomethacin treatment outcome in preterm infants with PDA. This combination of clinical and genetic factors may facilitate targeted indomethacin use for PDA.
Aims: To identify clinical andgenetic factors associated with indomethacin treatment failure in preterm neonates with patent ductus arteriosus (PDA). Patients & Methods: This is a multicenter cohort study of 144 preterm infants (22-32 weeks gestational age) at three centers who received at least one treatment course of indomethacin for PDA. Indomethacin failure was defined as requiring subsequent surgical intervention. Results: In multivariate analysis, gestational age (AOR 0.76, 95% CI 0.60-0.96), surfactant use (AOR 9.77, 95% CI 1.15-83.26), and CYP2C9*2 (AOR 3.74; 95% CI 1.34-10.44) were each associated with indomethacin failure. Conclusion: Age, surfactant use, and CYP2C9*2 influence indomethacin treatment outcome in preterm infants with PDA. This combination of clinical and genetic factors may facilitate targeted indomethacin use for PDA.
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