Lund University Publications

@article{63a6a7a4-4913-47ae-bb9d-bdd67afcd1b6,
  abstract     = {{<p>Background: Postnatal insulin-like growth factor-1 (IGF-1) replacement with recombinant human (rh)IGF-1 and IGF binding protein-3 (rhIGF-1/rhIGFBP-3) is being studied as a potential treatment to reduce comorbidities of prematurity. We have recently reported on a phase II, multicenter, randomized, controlled trial comparing postnatal rhIGF-1/rhIGFBP-3 replacement with standard of care (SOC) in extremely preterm infants (NCT01096784). Maximum severity of retinopathy of prematurity was the primary endpoint of the trial and presence of GMH-IVH/PHI one of the pre-specified secondary endpoints. Infants therefore received serial cranial ultrasound scans (CUS) between birth and term age. In this post-hoc analysis we present a detailed analysis of the CUS data of this trial and evaluate the effect of postnatal rhIGF-1/rhIGFBP-3 replacement on the incidence of different kinds of brain injury in extremely preterm infants. Methods: This report is an exploratory post-hoc analysis of a phase II trial in which infants &lt;28 weeks gestational age were randomly allocated to rhIGF-1/rhIGFBP-3 or SOC. Serial cranial ultrasounds were performed between birth and term-equivalent age. Presence of germinal matrix hemorrhage and intraventricular hemorrhage (GMH-IVH), periventricular hemorrhagic infarction (PHI), post-hemorrhagic ventricular dilatation, and white matter injury (WMI) were scored by two independent masked readers. Results: The analysis included 117 infants; 58 received rhIGF-1/rhIGFBP-3 and 59 received SOC. A trend toward less grade II–III GMH-IVH and PHI was observed in treated infants vs. SOC. A subanalysis of infants without evidence of GMH-IVH at study entry (n = 104) showed reduced progression to GMH-IVH in treated infants (25.0% [13/52] vs. 40.4% [21/52]; not significant). No effects of rhIGF-1/rhIGFBP-3 on WMI were observed. Conclusion: The potential protective effect of rhIGF-1/rhIGFBP-3 on the occurrence of GMH-IVH/PHI appeared most pronounced in infants with no evidence of GMH-IVH at treatment start.</p>}},
  author       = {{Horsch, Sandra and Parodi, Alessandro and Hallberg, Boubou and Malova, Mariya and Björkman-Burtscher, Isabella M. and Hansen-Pupp, Ingrid and Marlow, Neil and Beardsall, Kathryn and Dunger, David and van Weissenbruch, Mirjam and Smith, Lois E.H. and Hamdani, Mohamed and Mangili, Alexandra and Barton, Norman and Ramenghi, Luca A. and Hellström, Ann and Ley, David}},
  issn         = {{2296-2360}},
  keywords     = {{brain injury; cerebral hemorrhage; extremely preterm; neonate; recombinant human IGF-1}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Pediatrics}},
  title        = {{Randomized Control Trial of Postnatal rhIGF-1/rhIGFBP-3 Replacement in Preterm Infants : Post-hoc Analysis of Its Effect on Brain Injury}},
  url          = {{http://dx.doi.org/10.3389/fped.2020.517207}},
  doi          = {{10.3389/fped.2020.517207}},
  volume       = {{8}},
  year         = {{2020}},
}