1. Corticosteroid response predicts bronchopulmonary dysplasia status at 36 weeks in preterm infants treated with dexamethasone: A pilot study
- Author
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Keith Feldman, Christopher R. Nitkin, Alain Cuna, Alexandra Oschman, William E. Truog, Michael Norberg, Michael Nyp, Jane B. Taylor, and Tamorah Lewis
- Subjects
Pulmonary and Respiratory Medicine ,Adrenal Cortex Hormones ,Pediatrics, Perinatology and Child Health ,Infant, Newborn ,Humans ,Pilot Projects ,Dexamethasone ,Infant, Premature ,Bronchopulmonary Dysplasia ,Retrospective Studies - Abstract
A major barrier to therapeutic development in neonates is a lack of standardized drug response measures that can be used as clinical trial endpoints. The ability to quantify treatment response in a way that aligns with relevant downstream outcomes may be useful as a surrogate marker for new therapies, such as those for bronchopulmonary dysplasia (BPD).To construct a measure of clinical response to dexamethasone that was well aligned with the incidence of severe BPD or death at 36 weeks' postmenstrual age.Retrospective cohort study.Level IV Neonatal Intensive Care Unit.Infants treated with dexamethasone for developing BPD between 2010 and 2020.Two models were built based on demographics, changes in ventilatory support, and partial pressure of carbon dioxide (pCONinety-five infants were treated with dexamethasone before 36 weeks. Compared to the baseline support and demographic data at the time of treatment, changes in ventilatory support improved ordinal model sensitivity and specificity. For the binary classification, BPD incidence was well aligned with risk levels, increasing from 16% to 59%.Incorporation of response variables as measured by changes in ventilatory parameters and pCO
- Published
- 2022