Diuretic Safety of Furosemide in Premature Infants at Risk of Bronchopulmonary Dysplasia

Assessing the safety and preliminary effectiveness of furosemide, which is often used to prevent bronchopulmonary dysplasia, in premature infants.

Summary

More than 60,000 infants are born ≤29 weeks gestational age each year in the United States, and nearly 40% of those develop bronchopulmonary dysplasia (BPD). Because the consequences of BPD can be catastrophic, neonatologists frequently use diuretics such as furosemide to reduce pulmonary edema, improve pulmonary mechanics, minimize exposure to mechanical ventilation, and, ultimately, to prevent BPD. The understanding of the safety profile of furosemide in premature infants, however, is limited.

The PTN is conducting a phase 2, randomized, multicenter, placebo-controlled, dose-escalating, double-masked safety study to evaluate the safety and preliminary effectiveness of furosemide in premature infants at risk of BPD. Approximately 120 infants will be enrolled at ~30 sites. Total duration of study participation is 35 days (28 days of treatment and 7 days of safety monitoring).

Publications

 

OVERVIEW

Status:
Enrolling

ClinicalTrials.gov identifier:
NCT02527798

NICHD Data and Specimen Hub (DASH):
Infants Exposed to Furosemide or Bumetanide

Principal Investigators:
Matthew Laughon, MD, MPH
University of North Carolina
Chapel Hill, NC

P. Brian Smith, MD, MPH, MHS
Duke Health, Durham, NC

Label Change

  • Based on PK results obtained from 51 premature infants (23-29 weeks gestational age (GA)) receiving repeated doses up to 4 times the maximum recommended total daily dose for intravenous (IV) administration (or 8 times the maximum recommended total daily dose for enteral administration), body weight and postnatal age were found to have an impact on furosemide clearance.
  • Median clearance (normalized by dosing weight) was observed to increase from 8.9 (range: 2.1-21.2) ml/h/kg in infants with postnatal age (PNA) <30 days to 25.3 (range: 8.3 to 44.2) ml/h/kg in infants with PNA >30 days.
  • In addition, higher clearance was observed in infants with higher body weight. Bioavailability of enteral dose compared to IV dose was estimated to be around 79%.

 

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