Association of cytochrome P450 CYP2C9 (rs1057910) gene polymorphism and ibuprofen response in preterm neonates diagnosed with patent ductus arteriosus.

Abstract

Background: Patent ductus arteriosus (PDA) closure is one of the most significant changes necessary to transition to extrauterine life. The failure of closure in preterm infants has been associated with a variety of complications.

Aim and objectives: This study aim to investigate the correlation between cytochrome P450 CYP2C9 gene polymorphism and the response to ibuprofen treatment in preterm neonates with PDA.

Subjects and methods: This prospective study was conducted on 64 preterm neonates with patent ductus arteriosus (hsPDA). The neonates were treated with ibuprofen and diagnosed using clinical and echocardiographic examinations. The study was carried out at the Neonatal Intensive Care Unit (NICU), Pediatric Department, Kasr Alainy and ElMounira Pediatric Hospitals, Cairo University, in June 2018.

Results: A statistically significant difference in respiratory rate was observed between both groups (p = 0.047). Additionally, there was a significant difference in the duration of treatment with ibuprofen (p = 0.021). Treatment with ibuprofen had no impact on renal function parameters. The platelet count decreased after treatment with no statistical difference.

Conclusion: Use of Oral ibuprofen is a highly effective treatment for HsPDA in preterm neonates, demonstrating a remarkable success rate of 92.2% and fewer adverse effects. Whilst no correlation between the CYP2C9 (rs1057910) gene polymorphism and the efficacy of oral ibuprofen response, Other factors affecting the response of oral ibuprofen and subsequent PDA closure include gestational age, birth weight, Apgar score at 5 min, ductal diameter, RDS, and sepsis.