Isoprostanes levels in urine of preterm newborns treated with ibuprofen for PDA closure

Ibuprofen (IBU), an alternative non steroid antinflammatory drug (NSAID), has been proposed for the treatment of PDA in the newborn due to the lower reduction in cerebral, renal and mesenteric blood flow when compared with indomethacin. The present study tests the hypothesis that an OS may occur in neonate with PDA. Secondary we verified whether IBU for PDA therapy induces changes in urinary isoprostane (iPs) levels. Thirty fi e preterm babies < 33 weeks were studied prospectively. Three urine samples were collected: before and after IBU treatment and 7 days after the end of treatment. No differences were found between urinary levels of iPs at time 0. A statistically significant difference was found in iPs time behaviour between newborns treated with IBU and control ones (Kruskal-Wallis: p = 0.04 versus p = NS). Time trend showed a significant decrease in iPs from time 0 to time 1 after IBU therapy (p = 0.03) followed by an increase in iPs levels 7 days after the treatment (p = 0.04). No difference existed in control group. IBU therapy for PDA closure showed to reduce the risk of OS related to free radical generation. This antioxidant effect of IBU may be beneficial in preterm babies with PDA who are at high risk for OS. The results of the present study pave the way for more larger randomized clinical trials to confirm the antioxidant effect of IBU therapy.