Study shows PH treatment needs drop as kids with BPD grow
Many need treatment as babies, but often stop medication around age 2
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Babies with bronchopulmonary dysplasia (BPD), a lung disorder that affects premature infants and can lead to pulmonary hypertension (PH), may require medications to help manage PH, but often stop requiring the drugs as they grow into toddlerhood, a study found.
“Providers noted a decrease in prescriptions of PH medications in children 2 years of age and older, as PH improves with age in most children with BPD,” the researchers wrote.
PH treatment for children with BPD is often not managed by doctors at centers that specialize in BPD, they added.
The study, “Outpatient Medication Prescribing Patterns in Bronchopulmonary Dysplasia: A Survey of Clinical Practices and Challenges,” was published in Pediatric Pulmonology.
BPD mainly affects children who were born early and required medical interventions, such as ventilation or supplemental oxygen, to help them breathe. These interventions can be life-saving for premature babies, but they can put stress on their underdeveloped lungs. Lung damage from these interventions can lead to a range of complications, including PH, characterized by elevated pressure in the vessels that carry blood from the heart to the lungs.
Treatment ‘consistent’ despite ‘paucity of guidelines’ for care
There are no well-established guidelines for how to care for children with BPD. The scientists surveyed centers that specialize in BPD treatment, aiming to get a picture of typical care that children with BPD receive. They received answers from 27 centers in the U.S. and two centers abroad.
“Despite the paucity of literature or guidelines for medication use in infants and children with BPD this study identified several consistent practice patterns across centers,” the researchers wrote.
They found that doctors prescribed treatments for BPD primarily based on the extent of a patient’s symptoms, rather than on the severity of the disease. However, for most treatments, medication frequency was associated with disease severity. This was also true for PH therapies, with data showing that patients with more severe BPD were much more likely to be on PH treatment.
The use of PH therapies also showed an association with age that wasn’t seen with most other treatments. Specifically, the use of PH medicines tended to drop once patients reached about age 2. The researchers said this is consistent with prior data indicating that PH usually eases with age in children with BPD.
The scientists noted that most medicines prescribed to children with BPD were prescribed by doctors at the specialty center, but this wasn’t the case for PH. Children were more likely to be prescribed PH therapies by other specialists. Prescriptions for medicines used to treat acid reflux ( gastroesophageal reflux disease, or GERD) were evenly split among primary care providers, doctors at the BPD center, and other specialists.
“BPD outpatient providers report being the primary prescribers of most medications, though many co-manage GERD and PH therapy with general pediatricians and other subspecialists, highlighting the need for an interdisciplinary team approach,” the researchers wrote. “Our findings speak to the need for further refinement of clinical practice guidelines for medication use to support the longitudinal outpatient care of infants and children with BPD.”
