Comparison of efficacy between beractant and poractant alfa in respiratory distress syndrome among preterm infants (28–33+6 weeks gestational age) using the less invasive surfactant administration (LISA) technique: A randomized controlled trial

Abstract

Objective: Exogenous surfactant therapy is vital in managing respiratory distress syndrome (RDS) in preterm infants, with less invasive surfactant administration (LISA) gaining popularity. This study aimed to assess the e cacy and short-term outcomes of LISA using beractant and poractant alfa.Study Design: In a randomized controlled trial , we enrolled preterm infants (28-33 +6 weeks) with RDS requiring surfactant. LISA was employed, with beractant at 100 mg/kg or poractant-alfa at 200 mg/kg. Primary outcome was the need for intubation within 72 hours.Results: Among 120 infants, 3.3% in both groups required intubation within 72 hours (p value 1.00, 95% CI 0.14 -6.86). No signi cant differences in secondary outcomes were noted, except a trend towards increased necrotizing enterocolitis with beractant . Beractant was signi cantly more economical.Conclusion: Beractant and poractant-alfa exhibit similar e cacy in LISA for preterm infants with RDS.Economic considerations, especially in LMICs, favour beractant.The trial is registered in the clinical trial registry of India (CTRI/2023/03/050375).