Up until now indomethacin is the most extensively evaluated non-steroidal anti-inflammatory drug (NSAID) in neonatal medicine. If used with due consideration to the physiologic role of prostaglandins, a 90 success rate can be reached and serious adverse drug effects prevented.
Conclusion: The results reported by Bellander et al. support the idea that we do not need to study other substances of the same therapeutic class, with the same target--cyclooxygenase--in the prostaglandin cascade and with a similar pharmacological profile. Instead, indomethacin treatment regimes should be further improved with respect to their efficacy and safety.