A Comparison between the Two Surfactants, Beracsurf and Curosurf, in the Treatment of Respiratory Distress Syndrome (RDS) in Premature Infants

Document Type : Original Article

Authors

1 Mother and Newborn Health Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Department of Community and Preventive Medicine, Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Abstract

Background: Respiratory distress syndrome (RDS) in premature infants results from surfactant deficiency. Given the high cost and limited availability of Curosurf, we compared its outcomes with the Iranian surfactant Beracsurf. Methods: This descriptive cross-sectional study included premature infants (≤34 weeks) with RDS who met surfactant criteria. We assessed hospitalization duration, mechanical ventilation time, delivery mode, CPAP duration, Apgar score, gestational age, and clinical outcomes (discharge/mortality). Complications (pneumothorax, pulmonary/intraventricular hemorrhage, BPD, ROP, NEC), surfactant redosing frequency, and time to FiO₂<40% were compared between groups. Results: A total of 80 infants were divided into two equal groups (40 each). Baseline demographics were similar (P>0.05). Beracsurf recipients required significantly longer mechanical ventilation (3.25 vs. 2.22 days, P=0.01) and CPAP (3.05 vs. 2.41 days, P=0.04) than Curosurf recipients. No significant differences were observed in other complications, hospitalization duration, or mortality.                                                                                                                    Conclusion: Curosurf provided significantly shorter durations of respiratory support compared to Beracsurf. Other outcomes and complication rates were comparable. Further large-scale studies are warranted to guide clinical and economic decisions.

Keywords


  1. Rodriguez RJ. Management of respiratory distress syndrome: an update. Respir Care 2003; 48(3): 279‑87.
  2. Ancel PY, Goffinet F, EPIPAGE-2 Writing Group, Kuhn P, Langer B, Matis J, Hernandorena X, et al. Survival and morbidity of preterm children born at 22 through 34 weeks' gestation in France in 2011: results of the EPIPAGE-2 cohort study. JAMA Pediatr 2015; 169(3): 230-8.
  3. Sweet DG, Carnielli VP, Greisen G, Hallman M, Klebermass-Schrehof K, Ozek E, et al. European consensus guidelines on the management of respiratory distress syndrome – 2022 update. Neonatology. 2023; 120(1): 3-23.
  4. Polin RA, Carlo WA, Committee on Fetus and Newborn, American Academy of Pediatrics. Surfactant replacement therapy for preterm and term neonates with respiratory distress. Pediatrics 2014; 133(1): 156-63.
  5. Jobe AH, Ikegami M, Seidner SR, Pettenazzo A, Ruffini L. Surfactant phosphatidylcholine metabolism and surfactant function in preterm, ventilated lambs. Am Rev Respir Dis 1989; 139(2): 29‑53.
  6. Hawgood S, Clements JA. Pulmonary surfactant and its apoproteins. J Clin Invest 1990; 86(1): 1‑6.
  7. Benson BJ. Genetically engineered human pulmonary surfactant. Clinics in Perinatology 1993; 20(4): 791‑811.
  8. Moya FR, Montes HF, Thomas VL, Mouzinho AM, Smith JF, Rosenfeld CR. Surfactant protein A and saturated phosphatidylcholine in respiratory distress syndrome. Am J Respir Crit Care Med 1994; 150(6): 1672‑7.
  9. Najib KS, Barzegar H, Rezaei M, Davood M. A Comparison of the Effect of Beractant (Beracsurf) and Proctant Alpha (Curosurf) in Neonatal Respiratory Distress: A Randomized Controlled Trial. Iran J Med Sci 2025; 50(3): 171-8.
  10. Nourollahi S, Hashemi F, Shafiei E, Pirinegad O. Comparing the effectiveness of curosurf and beraksurf in the treatment of respiratory distress in premature infants. Int J Pediatr 2022; 10(5): 15992‑7.
  11. Yalaz M, Arslanoglu S, Akisu M, Atik T, Ergun O, Kultursay N. A comparison of efficacy between two natural exogenous surfactant preparations in premature infants with respiratory distress syndrome. Klin Padiatr 2004; 216(4): 230‑5.
  12. Baroutis G, Kaleyias J, Liarou T, Papathoma E, Hatzistamatiou Z, Costalos C. Comparison of three treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome. Eur J Pediatr 2003; 162(7): 476‑80.
  13. Mostafa Gharehbaghi M, Sarbakhsh P, Hosseini M, Gharibzadeh S, Shaseb E. A Randomized, Single‑blind, Comparison Trial of Beractant (BeraksurfTM) versus Poractant Alfa (Curosurf®) in the Treatment of Respiratory Distress Syndrome in Preterm Infants. Pharm Sci 2023, 29(1): 52-58.
  14. Najafian B, Karimi‑Sari H, Khosravi MH, Nikjoo N, Amin S, Shohrati M. Comparison of efficacy and safety of two available natural surfactants in Iran, Curosurf and Survanta in treatment of neonatal respiratory distress syndrome: A randomized clinical trial. Contemp Clin Trials Commun. 2016; 3: 55‑9.
  15. Mussavi M, Mirnia K, Asadollahi K. Comparison of the Efficacy of Three Natural Surfactants (Curosurf, Survanta, and Alveofact) in the Treatment of Respiratory Distress Syndrome Among Neonates: A Randomized Controlled Trial. Iran J Pediatr 2016; 26(5): e23705.
  16. Ramanathan R, Rasmussen MR, Gerstmann DR, Finer N, Sekar K, Group nTNAS. A randomized, multicenter masked comparison trial of poractant alfa (Curosurf) versus beractant (Survanta) in the treatment of respiratory distress syndrome in preterm infants. Am J Perinatol 2004; 21(03): 109‑19.