Comparison of efficacy and safety of two available natural surfactants in Iran, Curosurf and Survanta in treatment of neonatal respiratory distress syndrome: A randomized clinical trial

Abstract

IntroductionThe benefit of surfactant prescription for respiratory distress syndrome (RDS) has been approved. Curosurf and Survanta are two commonly used natural surfactants in Iran. Previous studies did not report priority for one of these two drugs. The present study aimed to compare the effectiveness and safety of Curosurf and Survanta in treatment of RDS.MethodsIn this randomized clinical trial, neonates were born with RDS diagnosis in two governmental and referral hospitals of Tehran (the capital of Iran) in 2014 were randomly selected. Neonates were randomly assigned into two groups receiving 100 mg/kg Curosurf or Survanta as soon as possible after randomization. Complications, mortality and needing the second dose were compared between the two groups.ResultsA total 112 patients with the mean gestational age of 32.59 ± 3.39 weeks were evaluated (56 patients in each group). There were no significant differences regarding birth weight, gestational age, delivery method, and parity between the two groups (P > 0.05). The complications were occurred in 18 neonates (32.1%) of Curosurf group and 20 neonates (35.7%) of Survanta group (RR = 0.922, 95% CI = 0.617–1.379). There were no significant differences regarding complications, mortality, and needing nasal CPAP and endotracheal tube between the two groups. In the neonates with gestational age of 29–32 weeks the IVH and NEC incidence were significantly more in Curosurf group compared to Survanta group (27.8% vs 0% and 22.3% vs 0%, P < 0.05).ConclusionThere was no significant difference in complications or mortality between those two groups; however Curosurf was associated with less need of ET tube (in >32 birth weeks subgroup) and NCPAP (in 29–32 birth weeks subgroup) (p = 0.008). Further evaluations with longer follow-up duration are needed for comparing these two surfactants.

Beractant and poractant alfa in premature neonates with respiratory distress syndrome: a systematic review of real-world evidence studies and randomized controlled trials

“…Fourteen studies had mid-term to long-term outcomes (>72 h) [ 19 , 20 , 22 – 33 ], and 1 study had short-term outcomes (≤72 h) [ 21 ]. The criterion for gestational age was <37 or ≤37 wGA in five studies [ 22 , 24 , 25 , 29 , 32 ], <35 wGA in two studies [ 19 , 26 ], ≤32 wGA in three studies [ 20 , 27 , 28 ], <30 wGA in one study [ 31 ], 26–36 wGA in one study [ 33 ], and 24 to <30 wGA in one study [ 21 ]. Two studies simply stated that patients had to be preterm, without defining a specific gestational age [ 23 , 30 ].…”

“…Two studies simply stated that patients had to be preterm, without defining a specific gestational age [ 23 , 30 ]. Four studies imposed a limit on birth weight for enrollment: 700–1500 g [ 30 ], 750–1750 g [ 19 ], >750 g [ 26 ], and ≤2000 g [ 28 ]. The studies included between 30 and 293 patients.…”

Porcine versus bovine surfactant therapy for RDS in preterm neonates: pragmatic meta-analysis and review of physiopathological plausibility of the effects on extra-pulmonary outcomes

“…Additionally, we also searched PubMed, using key words and/or MeSH terms as described in the Additional file 1, looking for animal or human translational investigations on these mechanisms. Fig.1 illustrates the project flow-chart: we included 17 studies in the systematic review [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] and we excluded two papers from the meta-analysis, as they investigated two non-internationally marketed porcine surfactants [43,44]. Compared to our previous metaanalysis on respiratory endpoints, there was one more study reporting on the extra-pulmonary outcomes [45].…”

Neonatal Respiratory Distress Syndrome: Things to Consider and Ways to Manage

“…It primarily reduces the surface tension of liquid presented in terminal air spaces [57]. Lack of pulmonary surfactant is the main result of NRDS; so, prescription of pulmonary surfactant can augment respiratory function and pulmonary compliance resulting in elevated oxyhemoglobin level [58][59][60][61]. Lack of surfactant results in a chain of problems from collapsed lung, tissue damage, reduced oxygenation and impaired function of alveolar epithelium, resulting in altered production of surfactant [62].…”