Healthcare

In most countries, intravenous (IV) form of ibuproven are unavailable, instead the cost considered expensive when available than oral form of ibuproven.
However, the adverse events, effectiveness, and efficiency of oral ibuproven still questioned.

Due to this, the researchers investigated both form of ibuproven to address those issue.

Published on November 22 in the Pediatric, the researchers said that oral form of ibuproven more better than intravenous form with no greater adverse events, better patent ductus arterious (PDA), higher response rate, and considered cheapest costing.

The study authors, Dr. Omer Erdeve at the Zekai Tahir Burak Maternity Teaching Hospital in Ankara, and colleagues said that oral form of ibuproven was as safe as the intravenous form.

The researchers said that oral ibuproven was more effective than intravenous ibuproven for ductal closure in very low birth weigh infants.
The reason why the response rate of oral form ibuproven higher than intravenous form, because the absorption of oral form ibuproven is slower than intravenous form, and the longer half-life probably prolongs the time of contact with the ductus.

However, based on their study that involved 102 very low birth weight infants received either intravenous or enteral ibuproven at an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 hours, by second course of treatment as needed, cumulative closure rates were high in both groups and only one patient in each group required surgical ligation.

The researchers also monitored their kidney function by measuring the serum cystatin-C level, which they say “reflects the glomerular filtration rate (GFR) better than creatinine,” because preterm newborn infants have limited drug-metabolizing enzyme activity and putting them at particular risk of renal side effects.

As a results, compared with intravenous form of ibuproven group, the researchers found cystatin-C levels increased significantly in the oral group after treatment.
Even so, according to the authors, there was no significant difference in post-treatment cystatin-C levels between the two groups.

Dr. Erdeve stated that their data suggested that oral and intravenous ibuproven did not have any important renal side effects, as determined using the sensitive marker cys-C.
However, he added, “Although it was not clinically important, the increase in the cys-C level with the oral form suggests that patients wit borderline renal function should be evaluated and followed closely.”

Overall, the authors conclude that while oral ibuproven was more effective for ductal closure with on course of treatment, “the oral form was as safe as the intravenous form in terms of renal tolerance, hyperbilirubinemia, gastrointestinal perforation or bleeding, (necrotizing enterocolitis), intraventricular hemorrhage, (chronic lung disease), and pulmonary hypertension.”