INSURE Strategies

Conventional Treatment Strategies
Pharmacy Considerations
Leading the Way

Demonstrated Success With Early Rescue INSURE

When selecting a surfactant for administration via early rescue INSURE in infants with RDS, consider the demonstrated experience of CUROSURF® (poractant alfa). In several studies, administering CUROSURF via the early rescue INSURE strategy resulted in both consistently high rates of single-dose success and significant reduction in the need for subsequent MV vs alternate methods.1-4

CUROSURF® (poractant alfa) delivers consistently high rates of single-dose success

CUROSURF and early rescue INSURE: single-dose success*1-4

CUROSURF and early rescue

*Single-dose success is defined as no need for repeat doses of CUROSURF® (poractant alfa).

Low MV rates following early rescue INSURE with CUROSURF® (poractant alfa)1-4

Need for MV following early rescue INSURE with CUROSURF1-4

CLINICAL STUDY GESTATIONAL AGE BIRTH WEIGHT SURFACTANT DOSING
THRESHOLD
% REQUIRING MV FOLLOWING EARLY RESCUE INSURE WITH CUROSURF
Verder H, et al. 1999* 27 weeks (median)
25-29 weeks (range)
950 g (median)
665-1600 g (range)
Fi02=0.37-0.55 25%
Dani C, et al. 2004* 29.0 ± 2.2 weeks 1078 ± 321 g Fi02 ≥ 0.30 15%
Bohlin K, et al. 2007 (retrospective) 29.2 ± 1.8 weeks 1333 ± 392 g Fi02 = 0.45 19%
Leone F, et al. 2013* (retrospective) 31 weeks (median)
30-33 weeks (range)
1660 g (median)
1180 g-2100 g (range)
Fi02 = 0.45 8%

*Need for MV before discharge. Need for MV during the first week after surfactant treatment

It is important to note that the INSURE strategy may not be appropriate for all infants. Infants with RDS may vary markedly in the severity of respiratory disease, maturity, and presence of other complications, and thus it is necessary to individualize patient care.

  • Across studies, administering CUROSURF via the early rescue INSURE strategy significantly reduced the need for subsequent MV vs alternate methods1-4
  • In all 4 studies, infants were extubated within approximately 5-10 minutes following surfactant administration1-4

Rapid extubation after surfactant administration may not be achievable or desirable in the most immature infants, and decisions to extubate should be individualized.