Outpatient prescription of pulmonary vasodilator therapy to preterm children with bronchopulmonary dysplasia

Jeremiasen, IdaLund University,Lunds universitet,Kärlväggsbiologi,Forskargrupper vid Lunds universitet,Barnkardiologi,Vessel Wall Biology,Lund University Research Groups,Children cardiology,Skåne University Hospital (författare)

Aim: The use of pulmonary vasodilator therapy in children born preterm is largely unknown. Our aim was to map prescription patterns in children with bronchopulmonary dysplasia in Sweden.Methods: This was a descriptive national registry-based study of children <7 years who had been prescribed a pulmonary vasodilator during 2007–2017, were born preterm and classified as having bronchopulmonary dysplasia. Information on prescriptions, patient characteristics and comorbidities were retrieved from the Swedish Prescribed Drug Register and linked to other national registers.Results: The study included 74 children, 54 (73%) born at 22–27 weeks' gestation and 20 (27%) at 28–36 weeks. Single therapy was most common, n = 64 (86.5%), and sildenafil was prescribed most frequently, n = 69 (93%). Bosentan, iloprost, macitentan and/or treprostinil were used mainly for combination therapies, n = 10 (13.5%). Patent ductus arteriosus or atrial septal defect were present in 29 (39%) and 25 (34%) children, respectively, and 20 (69%) versus 3 (12%) underwent closure. Cardiac catheterisation was performed in 19 (26%) patients. Median duration of therapy was 4.6 (1.9-6.8, 95% CI) months. Mortality was 9%.Conclusion: Preterm children with bronchopulmonary dysplasia were prescribed pulmonary vasodilators, often without prior catheterisation. Sildenafil was most commonly used. Diagnostic tools, effects, and drug safety need further evaluation.

Tran-Lundmark, KarinLund University,Lunds universitet,Kärlväggsbiologi,Forskargrupper vid Lunds universitet,WCMM- Wallenberg center för molekylär medicinsk forskning,Medicinska fakulteten,Vessel Wall Biology,Lund University Research Groups,WCMM-Wallenberg Centre for Molecular Medicine,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-kt_ (författare)
Dolk, MikaelaLund University,Lunds universitet,Kärlväggsbiologi,Forskargrupper vid Lunds universitet,Barnkardiologi,Vessel Wall Biology,Lund University Research Groups,Children cardiology,Skåne University Hospital(Swepub:lu)med-mdk (författare)
Naumburg, EstelleUmeå University,Umeå universitet,Pediatrik(Swepub:umu)esna0003 (författare)
KärlväggsbiologiForskargrupper vid Lunds universitet (creator_code:org_t)

Av författaren/redakt...: Jeremiasen, Ida; Tran-Lundmark, K ...; Dolk, Mikaela; Naumburg, Estell ...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Pediatrik

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