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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

Journal of Perinatology (2024)Cite this article

Subjects

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 efficacy 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 significant differences in secondary outcomes were noted. However, beractant was significantly more economical than poractant-alfa, with a significantly lower surfactant cost and total care cost for infant hospital stays.

Conclusion

Beractant and poractant-alfa exhibit similar efficacy in LISA for preterm infants with RDS. Economic considerations, especially in LMICs, favour beractant.

Clinical trial registation

(CTRI/2023/03/050375).

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Data availability

Available for viewing at https://docs.google.com/spreadsheets/d/1MLvBi_uUrPB0iJhz_wNn2IRUvMAX01Bb/edit?usp=drive_link&ouid=112878406867163161315&rtpof=true&sd=true.

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Acknowledgements

We would like to thank Dr Rajib Losan Bora for generation of random sequence and assigning participants to intervention.

Author information

Authors and Affiliations

  1. Department of Neonatology, Institute of Post Graduate Medical Education & Research and SSKM Hospital, 244, A J C Bose Road, Kolkata, PIN-700020, India

    Ashadur Zamal, Md Habibullah Sk & Bijan Saha

  2. Department of Pharmacology, Institute of Post Graduate Medical Education & Research and SSKM Hospital, 244, A J C Bose Road, Kolkata, PIN-700020, India

    Avijit Hazra

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Contributions

AZ conceived and designed the study, formulated the protocol, managed patient care, and prepared the initial draft. HSk contributed to protocol development, coordinated and supervised data collection, and reviewed and revised the manuscript at all stages. BS assisted in protocol development, coordinated data collection, and provided oversight, while also contributing to the review and revision of the manuscript. AH played a key role in protocol development, critically reviewed the manuscript to enhance its content, and performed the statistical analysis of the data. All authors have given their approval for the final manuscript as submitted and have committed to being accountable for all aspects of the work.

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Correspondence to Bijan Saha.

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Informed consent was obtained from the legal guardians of all included participants.

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Zamal, A., Sk, M.H., Saha, B. et al. 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. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01962-y

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