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Poractant alfa in respiratory distress syndrome in preterm infants: a profile of its use

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Abstract

Poractant alfa (Curosurf®) is a natural, porcine-derived surfactant that is well established as an effective and generally well-tolerated agent in the treatment of respiratory distress syndrome (RDS) in preterm infants. The efficacy of poractant alfa in RDS is better than that of early-generation synthetic surfactants, and limited data are available regarding its efficacy versus new-generation synthetic agents. Poractant alfa 200 mg/kg is more effective than poractant alfa 100 mg/kg or bovine-derived beractant 100 mg/kg. Techniques for administering poractant alfa include via an endotracheal tube or less invasive techniques [e.g. less invasive surfactant administration (LISA)] performed during non-invasive ventilation of spontaneously breathing infants via nasal continuous positive airway pressure (CPAP). Administration of poractant alfa 200 mg/kg in early rescue [i.e. fraction of inspired oxygen (FiO2) ≥ 0.3] via LISA is associated with increased successful management on continuous positive airway pressure, as well as reductions in the incidence of bronchopulmonary dysplasia (BPD) and death/BPD.

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Acknowledgements

The article was reviewed by: A. A. Fujii, Department of Pediatrics, Boston Medical Centre, Boston MA, USA; R. Ramanathan, Division of Neonatal Medicine, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. During the peer review process, the marketing authorization holder of poractant alfa was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Kate McKeage & Katherine A. Lyseng-Williamson

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  1. Kate McKeage
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Correspondence to Katherine A. Lyseng-Williamson.

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The preparation of this review was not supported by any external funding.

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K. McKeage and K. A. Lyseng-Williamson are employees of Adis/Springer, are responsible for the article content and declare no conflicts of interest. Additional information about this Adis Drug Review can be found at http://www.medengine.com/Redeem/AFD8F060014061F3.

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McKeage, K., Lyseng-Williamson, K.A. Poractant alfa in respiratory distress syndrome in preterm infants: a profile of its use. Drugs Ther Perspect 33, 455–462 (2017). https://doi.org/10.1007/s40267-017-0437-3

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