The oxytocin antagonist atosiban versus the beta-agonist terbutaline in the treatment of preterm labor. A randomized, double-blind, controlled study

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doi:10.1034/j.1600-0412.2001.080005413.x

Cited by 22 publications

(2 citation statements)

References 41 publications

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“…Details of the characteristics of the trials and comparison of the quality of tocolytic studies retrieved are reported elsewhere 16. Twenty five trials contained a placebo arm (26%),27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 60 included beta mimetics (63%),27 28 29 31 34 35 36 37 39 43 46 48 50 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 29 included magnesium sulfate (31%),29 30 33 38 47…”

Section: Resultsmentioning

confidence: 99%

Tocolytic therapy for preterm delivery: systematic review and network meta-analysis

Haas

Caldwell

Kirkpatrick

et al. 2012

BMJ

342

235

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Objective To determine the most effective tocolytic agent at delaying delivery.Design Systematic review and network meta-analysis. Study selection Randomised controlled trials of tocolytic therapy in women at risk of preterm delivery. Data sources Data extractionAt least two reviewers extracted data on study design, characteristics, number of participants, and outcomes reported (neonatal and maternal). A network meta-analysis was done using a random effects model with drug class effect. Two sensitivity analyses were carried out for the primary outcome; restricted to studies at low risk of bias and restricted to studies excluding women at high risk of preterm delivery (those with multiple gestation and ruptured membranes). ResultsOf the 3263 titles initially identified, 95 randomized controlled trials of tocolytic therapy were reviewed. Compared with placebo, the probability of delivery being delayed by 48 hours was highest with prostaglandin inhibitors (odds ratio 5.39, 95% credible interval 2.14 to 12.34) followed by magnesium sulfate (2.76, 1.58 to 4.94), calcium channel blockers (2.71, 1.17 to 5.91), beta mimetics (2.41, 1.27 to 4.55), and the oxytocin receptor blocker atosiban (2.02, 1.10 to 3.80). No class of tocolytic was significantly superior to placebo in reducing neonatal respiratory distress syndrome. Compared with placebo, side effects requiring a change of medication were significantly higher for beta mimetics (22.68, 7.51 to 73.67), magnesium sulfate (8.15, 2.47 to 27.70), and calcium channel blockers (3.80, 1.02 to 16.92). Prostaglandin inhibitors and calcium channel blockers were the tocolytics with the best probability of being ranked in the top three medication classes for the outcomes of 48 hour delay in delivery, respiratory distress syndrome, neonatal mortality, and maternal side effects (all cause).Conclusions Prostaglandin inhibitors and calcium channel blockers had the highest probability of delaying delivery and improving neonatal and maternal outcomes.

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Section: Resultsmentioning

confidence: 99%

Tocolytic therapy for preterm delivery: systematic review and network meta-analysis

Haas

Caldwell

Kirkpatrick

et al. 2012

BMJ

342

235

View full text Add to dashboard Cite

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“…It has been demonstrated to be effective for this indication [1213]. The first study that used atosiban in stimulated IVF cycles was published in 2007 [14].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of oxytocin antagonist infusion in improvingin vitrofertilization outcomes on the day of embryo transfer: A meta-analysis

Kim

Han

Kim

et al. 2016

Clin Exp Reprod Med

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ObjectiveUterine contraction induced by the embryo transfer (ET) process has an adverse effect on embryo implantation. The aim of this study was to determine the effect of oxytocin antagonist supplementation on the day of ET on in vitro fertilization outcomes via a meta-analysis.MethodsWe performed a meta-analysis of randomized controlled trials (RCTs). Four online databases (Embase, Medline, PubMed, and Cochrane Library) were searched through May 2015 for RCTs that investigated oxytocin antagonist supplementation on the day of ET. Studies were selected according to predefined inclusion criteria and meta-analyzed using RevMan 5.3. Only RCTs were included in this study. The main outcome measures were the clinical pregnancy rate, the implantation rate, and the miscarriage rate.ResultsA total of 123 studies were reviewed and assessed for eligibility. Three RCTs, which included 1,020 patients, met the selection criteria. The implantation rate was significantly better in patients who underwent oxytocin antagonist infusion (19.8%) than in the control group (11.3%) (n=681; odds ratio [OR], 1.92; 95% confidence interval [CI], 1.25–2.96). No significant difference was found between the two groups in the clinical pregnancy rate (n=1,020; OR, 1.57; 95% CI, 0.92–2.67) or the miscarriage rate (n=456; OR, 0.76; 95% CI, 0.44–1.33).ConclusionThe results of this meta-analysis of the currently available literature suggest that the administration of an oxytocin antagonist on the day of ET improves the implantation rate but not the clinical pregnancy rate or miscarriage rate. Additional, large-scale, prospective, randomized studies are necessary to confirm these findings.

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Oxytocin receptor antagonists for inhibiting preterm labour

Flenady

Reinebrant

Liley

et al. 2014

Cochrane Database of Systematic Reviews

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This review did not demonstrate superiority of ORA (largely atosiban) as a tocolytic agent compared with placebo, betamimetics or CCB (largely nifedipine) in terms of pregnancy prolongation or neonatal outcomes, although ORA was associated with less maternal adverse effects than treatment with the CCB or betamimetics. The finding of an increase in infant deaths and more births before completion of 28 weeks of gestation in one placebo-controlled study warrants caution. However, the number of women enrolled at very low gestations was small. Due to limitations of small numbers studied and methodological quality, further well-designed randomised controlled trials are needed. Further comparisons of ORA versus CCB (which has a better side-effect profile than betamimetics) are needed. Consideration of further placebo-controlled studies seems warranted. Future studies of tocolytic agents should measure all important short- and long-term outcomes for women and infants, and costs.

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The oxytocin antagonist atosiban versus the beta-agonist terbutaline in the treatment of preterm labor. A randomized, double-blind, controlled study

Abstract: The efficacy of atosiban in the inhibition of preterm labor was shown to be comparable to terbutaline. Atosiban had a superior safety profile compared with terbutaline in terms of maternal and fetal adverse events, and comparable infant outcomes.

Cited by 22 publications

References 41 publications

Tocolytic therapy for preterm delivery: systematic review and network meta-analysis

Tocolytic therapy for preterm delivery: systematic review and network meta-analysis

Efficacy of oxytocin antagonist infusion in improvingin vitrofertilization outcomes on the day of embryo transfer: A meta-analysis

Oxytocin receptor antagonists for inhibiting preterm labour

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