A randomised controlled trial comparing epinephrine and dexamethasone to placebo in the treatment of infants with

Anna Heath1,2,3, David Rios4, Kristina I Vogel5

  • 1Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada. anna.heath@sickkids.ca.

Trials
|November 13, 2025
PubMed

Insights

The Bronchiolitis in Infants Placebo Versus Epinephrine and Dexamethasone (BIPED) study investigates if a combination treatment reduces infant hospitalizations for bronchiolitis. This trial aims to provide evidence on the efficacy of epinephrine and dexamethasone in managing this common childhood respiratory infection.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Clinical Trials

Background:

  • Bronchiolitis is a leading cause of infant hospitalization in developed countries.
  • Current treatment primarily involves supportive care, placing a significant burden on healthcare systems.
  • The Bronchiolitis in Infants Placebo Versus Epinephrine and Dexamethasone (BIPED) study addresses this need.

Purpose of the Study:

  • To evaluate the efficacy of a combination of epinephrine and dexamethasone in reducing hospitalisation for bronchiolitis in infants.
  • To assess the impact of this treatment on hospital admissions, healthcare visits, and costs within 21 days.
  • To determine if the combination therapy is superior to placebo in managing bronchiolitis.

Main Methods:

  • Phase III, multi-centre, randomized, controlled, double-blinded, placebo-controlled trial.
  • Participants are infants presenting to the emergency department with bronchiolitis.
  • The study compares a combination of epinephrine and dexamethasone against a placebo.

Main Results:

  • The study is designed to determine if epinephrine and dexamethasone reduce the need for hospitalisation up to 7 days post-presentation.
  • Secondary outcomes include emergency department admissions, all-cause hospital admissions, healthcare visits, and associated costs.
  • Safety outcomes such as gastrointestinal bleeding, serious bacterial infections, and death are monitored.

Conclusions:

  • The BIPED study will provide crucial evidence on the effectiveness of combined epinephrine and dexamethasone for infant bronchiolitis.
  • Analysis will be conducted using a pre-defined statistical analysis plan (SAP) to ensure unbiased results.
  • Findings will inform clinical practice regarding the management of bronchiolitis in emergency departments.
Abstract

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