Multi-centre, randomised non-inferiority trial of early treatment versus expectant management of patent ductus arteriosus in preterm infants (the BeNeDuctus trial): statistical analysis plan.

Bronchopulmonary dysplasia Ductal ligation Expectant management Ibuprofen Mortality Necrotising enterocolitis Neonatal intensive care unit Patent ductus arteriosus Prematurity Statistical analysis plan

Journal

Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253

Informations de publication

Date de publication:
15 Sep 2021
Historique:
received: 13 04 2021
accepted: 01 09 2021
entrez: 16 9 2021
pubmed: 17 9 2021
medline: 18 9 2021
Statut: epublish

Résumé

Controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants. A persistent PDA is associated with neonatal mortality and morbidity, but causality remains unproven. Although both pharmacological and/or surgical treatment are effective in PDA closure, this has not resulted in an improved neonatal outcome. In most preterm infants, a PDA will eventually close spontaneously, hence PDA treatment potentially increases the risk of iatrogenic adverse effects. Therefore, expectant management is gaining interest, even in the absence of convincing evidence to support this strategy. The BeNeDuctus trial is a multicentre, randomised, non-inferiority trial assessing early pharmacological treatment (24-72 h postnatal age) with ibuprofen versus expectant management of PDA in preterm infants in Europe. Preterm infants with a gestational age of less than 28 weeks and an echocardiographic-confirmed PDA with a transductal diameter of > 1.5 mm are randomly allocated to early pharmacological treatment with ibuprofen or expectant management after parental informed consent. The primary outcome measure is the composite outcome of mortality, and/or necrotizing enterocolitis Bell stage ≥ IIa, and/or bronchopulmonary dysplasia, all established at a postmenstrual age of 36 weeks. Secondary short-term outcomes are comorbidity and adverse events assessed during hospitalization and long-term neurodevelopmental outcome assessed at a corrected age of 2 years. This statistical analysis plan focusses on the short-term outcome and is written and submitted without knowledge of the data. ClinicalTrials.gov NTR5479. Registered on October 19, 2015, with the Dutch Trial Registry, sponsored by the United States National Library of Medicine Clinicaltrials.gov NCT02884219 (registered May 2016) and the European Clinical Trials Database EudraCT 2017-001376-28.

Sections du résumé

BACKGROUND BACKGROUND
Controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants. A persistent PDA is associated with neonatal mortality and morbidity, but causality remains unproven. Although both pharmacological and/or surgical treatment are effective in PDA closure, this has not resulted in an improved neonatal outcome. In most preterm infants, a PDA will eventually close spontaneously, hence PDA treatment potentially increases the risk of iatrogenic adverse effects. Therefore, expectant management is gaining interest, even in the absence of convincing evidence to support this strategy.
METHODS/DESIGN METHODS
The BeNeDuctus trial is a multicentre, randomised, non-inferiority trial assessing early pharmacological treatment (24-72 h postnatal age) with ibuprofen versus expectant management of PDA in preterm infants in Europe. Preterm infants with a gestational age of less than 28 weeks and an echocardiographic-confirmed PDA with a transductal diameter of > 1.5 mm are randomly allocated to early pharmacological treatment with ibuprofen or expectant management after parental informed consent. The primary outcome measure is the composite outcome of mortality, and/or necrotizing enterocolitis Bell stage ≥ IIa, and/or bronchopulmonary dysplasia, all established at a postmenstrual age of 36 weeks. Secondary short-term outcomes are comorbidity and adverse events assessed during hospitalization and long-term neurodevelopmental outcome assessed at a corrected age of 2 years. This statistical analysis plan focusses on the short-term outcome and is written and submitted without knowledge of the data.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov NTR5479. Registered on October 19, 2015, with the Dutch Trial Registry, sponsored by the United States National Library of Medicine Clinicaltrials.gov NCT02884219 (registered May 2016) and the European Clinical Trials Database EudraCT 2017-001376-28.

Identifiants

pubmed: 34526095
doi: 10.1186/s13063-021-05594-x
pii: 10.1186/s13063-021-05594-x
pmc: PMC8444433
doi:

Substances chimiques

Ibuprofen WK2XYI10QM

Banques de données

ClinicalTrials.gov
['NCT02884219']

Types de publication

Equivalence Trial Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

627

Subventions

Organisme : ZonMw
ID : 843002622
Pays : Netherlands

Investigateurs

Peter H Dijk (PH)
Anton H L C van Kaam (AHLC)
Tessa de Baat (T)
Koen P Dijkman (KP)
Eduardo Villamor (E)
André A Kroon (AA)
Remco Visser (R)
Susanne M de Tollenaer (SM)
Filip Cools (F)
Marisse Meeus (M)
Anne-Britt Johansson (AB)
Frank Derriks (F)
Catheline Hocq (C)
Alexandra Zecic (A)
Tine Brink Henriksen (TB)
Kasper Jacobsen Kyng (KJ)

Informations de copyright

© 2021. The Author(s).

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Auteurs

Tim Hundscheid (T)

Radboud Institute for Health Sciences, Amalia Children's Hospital, Department of Paediatrics, Division of Neonatology, Radboud University Medical Centre Nijmegen, Internal postal code 804, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands. tim.hundscheid@radboudumc.nl.

Rogier Donders (R)

Department for Health Evidence, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands.

Wes Onland (W)

Emma Children's Hospital Amsterdam University Medical Centers, Department of Neonatology, University of Amsterdam, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.

Elisabeth M W Kooi (EMW)

Beatrix Children's Hospital, Department of Paediatrics, Division of Neonatology, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands.

Daniel C Vijlbrief (DC)

Utrecht University, Wilhelmina Children's Hospital, Division of Woman and Baby, Department of Neonatology, University Medical Centre Utrecht, Lundlaan 6, 3584, EA, Utrecht, The Netherlands.

Willem B de Vries (WB)

Wilhelmina Children's Hospital, Division of Woman and Baby, Department of Neonatology, University Medical Centre Utrecht, Utrecht University, Lundlaan 6, 3584, EA, Utrecht, The Netherlands.

Debbie H G M Nuytemans (DHGM)

Neonatology Network Netherlands (N3), p/a Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.

Bart van Overmeire (B)

Opgroeien, Flemish Government, Brussels, Belgium.

Antonius L Mulder (AL)

Department of Paediatrics, Division of Neonatology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.

Willem P de Boode (WP)

Radboud Institute for Health Sciences, Amalia Children's Hospital, Department of Paediatrics, Division of Neonatology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands.

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