Beta-blockers for congestive heart failure in children

Alabed, Samer; Sabouni, Ammar; Dakhoul, Suleiman Al; Bdaiwi, Yamama

doi:10.1002/14651858.cd007037.pub4

Cited by 30 publications

(10 citation statements)

References 47 publications

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“…Perhaps the most important aspect regarding the off-label practice, and one of the main advantages, is that it fulfills the unmet medical needs by the conventional therapeutic approaches, increasing the access to medication for special categories of patients. In agreement with the EC report on off-label use, the literature reveals that off-label practice is widespread in rare diseases [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ], oncology [ 12 , 13 , 14 , 15 , 16 ], pediatrics [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ], and psychiatry (especially in pediatric and elderly populations) [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. It is difficult to establish a prevalence or a pattern of general off-label prescribing, since it embraces many forms, and it is divided into many categories.…”

Section: Introductionsupporting

confidence: 75%

Off-Label Medication: From a Simple Concept to Complex Practical Aspects

Rusz

Ősz

Jîtcă

et al. 2021

IJERPH

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Off-label use of drugs is widely known as unapproved use of approved drugs, and it can be perceived as a relatively simple concept. Even though it has been in existence for many years, prescribing and dispensing of drugs in an off-label regimen is still a current issue, triggered especially by unmet clinical needs. Several therapeutic areas require off-label approaches; therefore, this practice is challenging for prescribing physicians. Meanwhile, the regulatory agencies are making efforts in order to ensure a safe practice. The present paper defines the off-label concept, and it describes its regulation, together with several complex aspects associated with clinical practices regarding rare diseases, oncology, pediatrics, psychiatry therapeutic areas, and the safety issues that arise. A systematic research of the literature was performed, using terms, such as “off-label”, ”prevalence”, ”rare diseases”, ”oncology”, ”psychiatry”, ”pediatrics”, and ”drug repurposing”. There are several reasons for which off-label practice remains indispensable in the present; therefore, efforts are made worldwide, by the regulatory agencies and governmental bodies, to raise awareness and to ensure safe practice, while also encouraging further research.

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Section: Introductionsupporting

confidence: 75%

Off-Label Medication: From a Simple Concept to Complex Practical Aspects

Rusz

Ősz

Jîtcă

et al. 2021

IJERPH

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“… 26 The few available studies on heart failure treatments in children have either failed to show an effect or have been underpowered. 27–29 Future studies are needed to address whether or not these patterns of increased prescription of CVM can affect clinical course or outcome in preterm children.…”

Section: Discussionmentioning

confidence: 99%

Preterm birth and prescriptions for cardiovascular, antiseizure, antibiotics and antiasthmatic medication in children up to 10 years of age: a population-based data linkage cohort study across six European regions

et al. 2022

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ObjectivesPreterm children are exposed to many medications in neonatal intensive care units, but little is known about the effect of prematurity on medication use throughout infancy and childhood. We examined prescriptions of cardiovascular medication (CVM), antiseizure medication (ASM), antiasthmatic medication and antibiotics issued/dispensed in the first 10 years of life for very and moderately preterm children compared with term.DesignPopulation-based data linkage cohort study linking information from birth records to prescription records.SettingSix registries from five countries in the EUROlinkCAT study.ParticipantsThe study population included 1 722 912 children, of whom 10 820 (0.6%) were very preterm (<32 weeks gestational age (GA)), 92 814 (5.4%) were moderately preterm (32–36 weeks GA), 1 606 643 (93.3%) were born at term (≥37 weeks GA) and 0.7% had missing GA. Children with major or minor congenital anomalies were excluded (including patent ductus arteriosus).Main outcome measuresRelative risk (RR) of receiving a prescription for CVM, ASM, antiasthmatic and antibiotics.ResultsVery preterm children had a higher RR of receiving a prescription for CVM and ASM than preterm children. For all preterm children, the RR of having a CVM prescription was 3.58 (95% CI 2.06 to 6.23); 2.06 (95% CI 1.73 to 2.41) for ASM; 1.13 (95% CI 0.99 to 1.29) for antiasthmatics and 0.96 (95% CI 0.93 to 0.99) for antibiotics in the first year of life. Increased prescription of CVM, ASM and antiasthmatics persisted for all 10 years of follow-up. Although the RR was highest for CVM and ASM, in absolute numbers more children received prescriptions for antibiotics (42.34%, 95% CI 38.81% to 45.91%) and antiasthmatics (28.40%, 95% CI 16.07% to 42.649%) than for CVM (0.18%, 95% CI 0.12% to 0.25%) and ASM (0.16%, 95% CI 0.13% to 0.20%) in the first year of life.ConclusionPreterm children had a higher risk of being prescribed/dispensed CVM, ASM and antiasthmatics up to age 10. This study highlights a need for further research into morbidity beyond age 10.

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“…Beta blockers can reduce heart rate. Three meta-analysis on the use of beta-blockers for congestive HF in children showed that children with congestive HF might bene t from treatment with these drugs [19][20][21]. Additionally, ivabradine is a novel drug which can reduce the heart rate.…”

Section: Discussionmentioning

confidence: 99%

Severe Heart Failure and Outcomes in 121 Children With Dilated Cardiomyopathy: A Single-Center Retrospective Study from Southwest China

Chen

Qin

et al. 2022

Preprint

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Objective Heart failure is a common complication in children with dilated cardiomyopathy. The aim of this study was to determine whether severe heart failure at diagnosis was related to poor outcomes in children with dilated cardiomyopathy. Methods We analyzed medical data from 121 children with dilated cardiomyopathy in our hospital from 2003 to 2021. The children were grouped by the degree of heart failure. Cox regression analysis was performed to confirm whether severe heart failure was associated with poor outcomes. Results There were 121 patients with dilated cardiomyopathy in this research. The mean age of the 121 patients was 118.5 ± 63.0 months. Of these patients, 81 (67.8%) were sorted into a severe heart failure group and 39 (32.2%) were placed into a mild heart failure group. A comparison between the two groups showed that patients with severe heart failure were older and more likely to be male, have lower systolic blood pressure measurements, be admitted to the intensive care unit and be treated with β-blockers, loop diuretics, spironolactone and digoxin. In addition, they had larger systolic and diastolic left ventricular end-diastolic dimensional and lower left ventricular ejection fractional z-scores as well as being more prone to aortic and tricuspid regurgitations (P < 0.05 in all cases). After adjusting for age, sex, heart rate, left ventricular ejection fraction z-scores and drug, severe heart failure was found to be independently associated with an increased risk of death (hazard ratio [HR] 2.27; P < 0.005). Conclusions Severe heart failure at diagnosis was related to a greater risk of death in children with dilated cardiomyopathy. Further prospective studies are warranted to evaluate the efficacy between the treatment undertaken for heart failure and outcomes in children with dilated cardiomyopathy.

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Beta-blockers for congestive heart failure in children

Cited by 30 publications

References 47 publications

Off-Label Medication: From a Simple Concept to Complex Practical Aspects

Off-Label Medication: From a Simple Concept to Complex Practical Aspects

Preterm birth and prescriptions for cardiovascular, antiseizure, antibiotics and antiasthmatic medication in children up to 10 years of age: a population-based data linkage cohort study across six European regions

Severe Heart Failure and Outcomes in 121 Children With Dilated Cardiomyopathy: A Single-Center Retrospective Study from Southwest China

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