Randomised controlled trial of allopurinol prophylaxis in very preterm infants.

Russell, G A; Cooke, R W I

doi:10.1136/fn.73.1.f27

Cited by 85 publications

(40 citation statements)

References 29 publications

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“…The limitations described above may explain some of the disappointing results from trials of antioxidants for the prevention of neonatal disease, including vitamin E (77-79), allopurinol (80), and selenium supplementation (81). The outcomes of other antioxidant interventions in ongoing trials, such as intratracheal recombinant human SOD (82), are yet to be determined.…”

Section: Antioxidant Approaches To Neonatal Diseasementioning

confidence: 99%

Antioxidants as Therapy in the Newborn: Some Words of Caution

2001

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Section: Antioxidant Approaches To Neonatal Diseasementioning

confidence: 99%

Antioxidants as Therapy in the Newborn: Some Words of Caution

2001

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“…At recruitment, the infants who subsequently developed BPD had significantly higher levels of hypoxanthine. There were, however, no statistically significant differences in BPD or other sequelae of prematurity between the two groups [96].…”

Section: Allopurinolmentioning

confidence: 62%

Advances in emerging treatment options to prevent bronchopulmonary dysplasia

Ling

Greenough

2017

Expert Opinion on Orphan Drugs

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Introduction: Bronchopulmonary dysplasia (BPD) is common sequaelae of premature birth.It can be complicated by the development of pulmonary hypertension (PH), which significantly increases mortality. Areas covered: The aim of this review is to evaluate emerging drug therapies for prevention and treatment of BPD and associated PH. These include superoxide dismutase, macrolides, Clara secretary cell protein, -1 protease inhibitors, pentoxifylline, melatonin, inositol, N-acetyl cysteine, allopurinol, cimetidine, pulmonary vasodilators and mesenchymal stem cells (MSC). We have also included discussion on longer standing therapies such as corticosteroids, caffeine and vitamin A.Expert opinion: Corticosteroid administration systemically, but not by inhalation, caffeine and vitamin A reduce BPD. Enhancing endogenous anti-oxidant mechanisms through supplementation with superoxide dismutase or Clara cell secretory protein has yielded encouraging results. Azithromycin, a macrolide used to treat Ureaplasma infection, also has anti-inflammatory properties and has been shown to reduce BPD. Sildenafil reduces the echocardiographic markers of pulmonary hypertension associated with BPD, but has not been shown to prevent BPD. In animal models and a small phase one study MSC administration has resulted in promising results. Appropriately powered studies with long term outcomes are required to assess the efficacy of all these treatments.3

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“…Allopurinol is a free radical scavenger and synthetic inhibitor of xanthine oxidase, which generates superoxide radicals following hypoxia. Nevertheless, in an RCT of 400 infants born between 24 and 32 weeks of gestation, allopurinol given enterally did not signifi cantly reduce BPD [69] . Melatonin is a potent free radical scavenger [65] , and in an RCT, melatonin administration was associated with signifi cantly lower levels of proinfl ammatory cytokines and reduced ventilatory requirements during the perinatal period [26] , but whether it reduces BPD requires testing.…”

Section: Antioxidantsmentioning

confidence: 92%

Perinatal prevention of bronchopulmonary dysplasia

Greenough

Ahmed

2012

Journal of Perinatal Medicine

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Bronchopulmonary dysplasia (BPD), defi ned as oxygen dependency for at least 28 days after birth, is a common adverse outcome of very premature birth. Affected children require frequent readmissions to hospital in the fi rst 2 years, and although lung growth and remodelling results in progressive improvement in lung function, airfl ow abnormalities may remain. Indeed, the most severely affected experience troublesome respiratory symptoms as adolescents and young adults. As a consequence, many potential preventative strategies have been investigated, and some have resulted in a reduction in BPD but with a negative risk/benefi t ratio, for example, postnatal corticosteroids. Others therapies, namely antenatal corticosteroids and postnatal surfactant, have resulted in signifi cant benefi ts to infants, including reductions in respiratory distress syndrome, necrotising enterocolitis, intraventricular haemorrhage and neonatal death, but have not impacted favourably on the incidence of BPD, perhaps due to the increased survival of very immature infants. In one major trial, it has been shown that BPD can be reduced without adverse effects by caffeine administration. Avoidance of high oxygen concentrations at resuscitation is also a promising approach to reduce BPD.

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Randomised controlled trial of allopurinol prophylaxis in very preterm infants.

Cited by 85 publications

References 29 publications

Antioxidants as Therapy in the Newborn: Some Words of Caution

Antioxidants as Therapy in the Newborn: Some Words of Caution

Advances in emerging treatment options to prevent bronchopulmonary dysplasia

Perinatal prevention of bronchopulmonary dysplasia

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