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Pharmacologic Management of Severe Bronchopulmonary Dysplasia

William E Truog1, Tamorah R Lewis2, Nicolas A Bamat3

  • 1Division of Neonatology, Children's Mercy-Kansas City and the Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO.

Neoreviews
|July 3, 2020
PubMed

Insights

Treating severe bronchopulmonary dysplasia (sBPD) in infants is challenging due to limited effective medications. This review explores individualized medication approaches, considering infant development and variable responses to therapies.

Area of Science:

  • Neonatology
  • Pharmacology
  • Pediatric Pulmonology

Background:

  • Severe bronchopulmonary dysplasia (sBPD) affects very preterm infants, with few effective treatments available.
  • Current research has not yielded clinically meaningful preventive therapies for sBPD in early postnatal life.

Purpose of the Study:

  • To review challenges in individualizing medication use for infants with sBPD.
  • To explore factors influencing variable infant responses to therapies.
  • To discuss the potential of antifibrotic medications for late-stage sBPD.

Main Methods:

  • Review of current literature on developmental pharmacology and pharmacogenetics related to sBPD.
  • Analysis of data on the variability of commonly prescribed drug use in sBPD.
  • Discussion of challenges in tailoring medication to infant age and developmental status.

Main Results:

  • Significant variability exists in the use and response to common sBPD medications.
  • Infant postmenstrual/postnatal age and developmental pharmacology impact drug efficacy.
  • Pharmacogenetics contributes to differing responses to therapeutic interventions.

Conclusions:

  • Individualized medication strategies are needed for sBPD, accounting for developmental factors.
  • Further research into developmental pharmacology and pharmacogenetics is crucial for optimizing infant treatment.
  • Antifibrotic agents show potential for managing the profibrotic state in late-stage sBPD.

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