{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T11:46:01Z","timestamp":1772538361371,"version":"3.50.1"},"reference-count":42,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2010,2,4]]},"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the effects of indomethacin or ibuprofen compared with placebo on closure, morbidity and mortality in preterm infants &lt;37 weeks' gestation with echocardiographically and\/or clinically important patent ductus arteriosus (PDA) at &gt;24 h of life.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data sources<\/jats:title>\n                  <jats:p>MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, Cochrane Library, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"controlled-trials.com\">controlled-trials.com<\/jats:ext-link>, American Pediatric and European Paediatric Research Societies and Effective Care of the Newborn Infant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Review methods<\/jats:title>\n                  <jats:p>Systematic review with network meta-analysis of randomised studies comparing intravenous indomethacin, ibuprofen or placebo for PDA in preterm infants at &gt;24 h of life.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ten trials compared intravenous indomethacin versus intravenous ibuprofen, nine intravenous indomethacin versus placebo and one intravenous ibuprofen versus placebo. Both intravenous indomethacin (pooled RR 2.39 (95% CI 2.05 to 2.78)) and intravenous ibuprofen (RR 2.40 (95% CI 2.03 to 2.84)) closed a PDA more effectively than placebo. Intravenous ibuprofen was associated with approximately 30% greater risk of chronic lung disease than intravenous indomethacin (RR 1.28 (95% CI 1.03 to 1.60)) or placebo (RR 1.29 (95% CI 0.99 to 1.70)). Differences in risk or benefit were not significant between any combination of intravenous indomethacin, intravenous ibuprofen or placebo groups for <jats:italic>intraventricular haemorrhage<\/jats:italic>, necrotising enterocolitis and death. Reporting on neurological outcomes was insufficient for pooling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Intravenous indomethacin or ibuprofen administered to preterm infants for PDA at &gt;24 h of life promoted ductal closure, but other short-term benefits were not seen. Treatment with intravenous ibuprofen may increase the risk of chronic lung disease. Good-quality evidence of treatment effect on morbidity, mortality and improved neurodevelopment is urgently needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/adc.2009.168682","type":"journal-article","created":{"date-parts":[[2010,9,28]],"date-time":"2010-09-28T20:24:11Z","timestamp":1285705451000},"page":"F45-F52","source":"Crossref","is-referenced-by-count":73,"title":["Network meta-analysis of indomethacin versus ibuprofen versus placebo for PDA in preterm infants"],"prefix":"10.1136","volume":"96","author":[{"given":"L J","family":"Jones","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P D","family":"Craven","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Attia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Thakkinstian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Wright","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2010,9,27]]},"reference":[{"key":"2025090510414547000_96.1.F45.1","doi-asserted-by":"publisher","DOI":"10.1159\/000087582"},{"key":"2025090510414547000_96.1.F45.2","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1203\/00006450-199106010-00010","article-title":"Patent ductus arteriosus, indomethacin, and intestinal distension: effects on intestinal blood flow and oxygen consumption","volume":"29","author":"Meyers","year":"1991","journal-title":"Pediatr Res"},{"key":"2025090510414547000_96.1.F45.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(84)80135-3"},{"key":"2025090510414547000_96.1.F45.4","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1767"},{"key":"2025090510414547000_96.1.F45.5","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1542\/peds.84.5.802","article-title":"Cerebral blood flow velocity changes in preterm infants after a single dose of indomethacin: duration of its effect","volume":"84","author":"Van Bel","year":"1989","journal-title":"Pediatrics"},{"key":"2025090510414547000_96.1.F45.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)83391-8"},{"key":"2025090510414547000_96.1.F45.7","doi-asserted-by":"crossref","unstructured":"Shah SS Ohlsson A . 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