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indometacin (IV) (Indocin IV)

✓ Approved

Merck & Co. · PTGS1 · Small Molecule

What is indometacin (IV)?

indometacin (IV) is a small molecule developed by Merck & Co.. It is approved for therapeutic indications via injectable (others) or intravenous (iv).

Drug Profile

Brand NamesIndocin IV
CompanyMerck & Co.
Drug ClassSmall Molecule
Molecular TargetPTGS1, PTGS2
RouteInjectable (Others), Intravenous (IV)
StatusApproved
Sources: ClinicalTrials.gov, Merck & Co.

Mechanism of Action

Molecular Targets

indometacin (IV) acts on 2 molecular targets:

PTGS1prostaglandin-endoperoxide synthase 1 (COX3, PCOX1)
PTGS2prostaglandin-endoperoxide synthase 2 (GRIPGHS, hCox-2)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

indometacin (IV) is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Congenital, familial and genetic disordersPatent ductus arteriosus✓ Approved

Related Research Articles

PubMedFrontiers in neurology2026-10-22

Early hemoglobin trajectories and short-term mortality in ICU patients with traumatic brain injury: development in MIMIC-IV and external assessment in eICU-CRD.

Li Saijie S, Han Yanyu Y, Ding Feiyu F, Qiu Zhichao Z et al.

Hemoglobin (Hb) changes dynamically after traumatic brain injury (TBI), but the prognostic relevance of distinct longitudinal patterns and their added value beyond early Hb remain uncertain. We characterized early Hb trajectories in ICU patients with TBI and examined associations with mortality after a 120-h landmark. MIMIC-IV was used for model development and multicenter eICU-CRD for external assessment. Daily median Hb values across five 24-h windows were modeled using a latent class linear mixed model. The three-class MIMIC-IV model was frozen before transport to eICU. Cox models evaluated mortality from 120 h through ICU day 28, with sensitivity analyses addressing selection, landmark attrition, simpler Hb summaries, classification uncertainty, PRBC exposure, missingness, and nonproportional hazards. In MIMIC-IV, 2,466 patients entered trajectory analysis and 2,409 entered post-landmark analysis. Three trajectories were identified: relatively high and stable, rapidly declining, and persistently low Hb. In fully adjusted models, rapidly declining (HR 1.74, 95% CI 1.18-2.57) and persistently low Hb (HR 1.57, 95% CI 1.19-2.08) were associated with higher mortality. In eICU, 2,097 patients were classified and 1,557 entered outcome analysis; persistently low Hb remained associated with mortality (HR 1.58, 95% CI 1.03-2.43), whereas the rapidly declining association was less precise (HR 1.24, 95% CI 0.80-1.92). Adding trajectory class to the MIMIC-IV clinical model increased the C-index from 0.786 to 0.792. After adjustment for first-day Hb, the rapidly declining trajectory remained associated with mortality (HR 1.77, 95% CI 1.20-2.62), whereas the persistently low association attenuated (HR 1.27, 95% CI 0.83-1.93). Independent three-class refitting in eICU did not recover the same latent-class structure (ARI 0.169). Early Hb trajectories after TBI showed distinct prognostic associations. Persistently low Hb had the most consistent transported association but was attenuated after first-day Hb adjustment; rapid decline retained an association in MIMIC-IV but had limited external support. Incremental discrimination was modest. These patterns should be interpreted as treatment-embedded clinical courses rather than fixed biological phenotypes or evidence for trajectory-specific transfusion thresholds.

PMID 42903095
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PubMedFrontiers in immunology2026-10-22

Phenotypic shift from active class IV lupus nephritis to lupus podocytopathy: a case report highlighting the treatment-altering role of repeat kidney biopsy.

Wang Zhifa Z, Deng Jinxiu J, Shen Jinfeng J, Jiang Hui H et al.

The underlying pathophysiological mechanisms of proteinuria relapse in lupus nephritis (LN) patients during immunological remission are complex, often involving non-immune complex-mediated podocyte injury. We report a 21-year-old male with class IV LN and thrombotic microangiopathy (TMA). After multi-target induction and maintenance therapy, the patient achieved complete clinical remission. During subsequent follow-up, he developed progressive nephrotic-range proteinuria while maintaining serological remission (persistently negative autoantibodies and normal complement levels). Intensification of conventional immunosuppressants was ineffective. A repeat kidney biopsy revealed significant resolution of immune complex deposits but prominent focal segmental glomerulosclerosis (FSGS)-like changes with extensive podocyte foot process effacement. The regimen was adjusted to a podocyte-targeted therapy centered on tacrolimus, resulting in a rapid and sustained reduction in proteinuria. This case suggests that in the clinico-serological dissociation phase of LN, repeat kidney biopsy is of significant clinical value for identifying pathological phenotypic shifts, avoiding excessive immunosuppression, and guiding precision medicine.

PMID 42903163
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PubMedFrontiers in neurology2026-10-22

Integrating 72-h BUN/Cr trajectories with interpretable machine learning for 28-day mortality after acute stroke: a dual-center landmark study.

Cheng Zihai Z, Lu Zhongsheng Z, Wang Shuren S, He Menghui M et al.

The blood urea nitrogen-to-creatinine ratio (BUN/Cr) may reflect renal perfusion and systemic stress, but its early course after acute stroke is unclear. We identified 72-h BUN/Cr trajectories and assessed their role in interpretable machine-learning evaluation of 28-day mortality. This dual-center landmark study included 2,805 ICU patients with acute ischemic stroke, nontraumatic intracerebral hemorrhage, or nontraumatic subarachnoid hemorrhage from the Medical Information Mart for Intensive Care IV (MIMIC-IV) version 3.1. Before modeling, patients were split into a training set (n = 1,964) and an internal test set (n = 841). The trajectory and prediction models developed in the training set were applied without modification to the internal test set and the Qinghai external validation cohort (n = 387). Eight algorithms and prespecified nested models were evaluated using Cox regression, discrimination, calibration, paired comparisons, decision curves, and TreeSHAP. A quadratic three-class model identified low/stable, high U-shaped, and rising-to-plateau patterns, with mortality rates of 21.6, 35.9, and 39.7%. Adjusted hazard ratios versus Class 1 were 1.87 (95% CI 1.25-2.79) for Class 2 and 1.73 (1.31-2.29) for Class 3. The training-selected Light Gradient Boosting Machine (LightGBM) achieved an AUROC of 0.734 (95% CI 0.695-0.773), a calibration slope of 0.894, and an O/E ratio of 1.015 in the internal test set. In the Qinghai external validation cohort, the AUROC was 0.624 (95% CI 0.559-0.689), the calibration slope was 0.459, and the O/E ratio was 1.920. Adding trajectory class to a model already containing routine clinical and static renal variables changed the AUROC by 0.003 in the internal test set (p = 0.515) and -0.014 in the Qinghai external validation cohort (p = 0.130), without a clear gain in discrimination. BUN/Cr trajectories were associated with post-landmark mortality and summarized the three-day renal course. Training-selected LightGBM showed moderate internal discrimination and underwent frozen external evaluation. Trajectory class added modest information beyond routine clinical and static renal variables, while the combined approach provides an interpretable framework for 72-h reassessment.

PMID 42903085
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PubMedNeuropsychological rehabilitation2026-10-22

Modifications to cognitive behavioural therapies for depression and anxiety in adults with neurological disorders: A qualitative analysis of intervention protocols.

Chappell Holly H, Woldhuis Thomas T, Wu Wendy W, Gandy Milena M

Cognitive and Behavioural-based Therapies (CBT) can effectively manage symptoms of depression and anxiety. However, adults with neurological disorders (NDs) often face cognitive, physical, and social challenges that make it difficult to engage with traditional forms of these treatments. To address this, CBT protocols have been modified to better suit the needs of this population. This study analysed 41 randomized controlled trials with modified CBT-based protocols for treating symptoms of depression and/or anxiety in adults with a ND. It spanned 10 different NDs : stroke, epilepsy, migraine, Parkinson's disease, acquired brain injury, multiple sclerosis, and dementia. Content analysis identified seven main categories of modification. These were: (i) neurologically tailored information and skills; (ii) facilitation of learning and retention of information; (iii) cognitive compensatory strategies; (iv) tailoring intervention to individual needs; (v) multi-modal aids of delivery; (vi) caregiver involvement or training; (vii) flexibility of session delivery. These categories were broadly grouped into three main principles of modification: (1) content adaptation, (2) delivery enhancement and (3) caregiver involvement. These findings support the clinical implementation of CBT for adults with NDs and may guide best practices for managing common mental health difficulties in this population.

PMID 42902797
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PubMedZhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics2026-10-22

[A multicenter study on the risk factors for in-hospital mortality in neonates with severe asphyxia at tertiary hospitals in Henan Province].

Pei Wan-Jun WJ, Zhang Yan-Hua YH, Li Shu-Jin SJ, Zhou Bian-Sheng BS et al.

To construct a risk prediction model for in-hospital mortality in neonates with severe asphyxia. A total of 836 neonates with severe asphyxia admitted to 20 tertiary hospitals in Henan Province between January 2022 and December 2025 were retrospectively enrolled and divided into a death group (n=267) and a survival group (n=569) according to outcome. Birth characteristics, resuscitation measures, and early complications were analyzed. Multivariable logistic regression was used to identify risk factors, and a nomogram prediction model was developed. Receiver operating characteristic curves, calibration curves, and decision curve analysis were used to evaluate the model's discrimination, calibration accuracy, and clinical applicability. Multivariable logistic regression showed that high lactate level, low birth weight, a 5-minute Apgar score of ≤5, use of epinephrine, volume expansion during resuscitation, persistent pulmonary hypertension of the newborn, pulmonary hemorrhage, shock, and grade III/IV intraventricular hemorrhage were independent risk factors for in-hospital mortality in neonates with severe asphyxia (P<0.05). The nomogram based on these risk factors yielded an area under the curve of 0.795 (95%CI: 0.762-0.827). Calibration and decision curve analyses indicated that the model had high accuracy and good clinical applicability. In-hospital mortality among severely asphyxiated neonates is closely associated with birth weight, resuscitation modalities, and early complications such as pulmonary hemorrhage and shock. The risk model constructed based on these factors shows good predictive value.

PMID 42902716
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PubMedFrontiers in nutrition2026-10-22

LVEF-defined septic cardiomyopathy modifies the association between the prognostic nutritional index and mortality in adults with sepsis: a 72-h landmark analysis.

Wang Xianju X, Cheng Min M, Ruan Fengqi F, Chen Chong C et al.

The prognostic nutritional index (PNI) combines albumin and lymphocyte count and may capture nutrition-related immune-inflammatory status in sepsis. Whether its association with mortality differs by left ventricular ejection fraction (LVEF)-defined septic cardiomyopathy (SCM) is unclear. We conducted a retrospective 72-h landmark study of MIMIC-IV adults with Sepsis-3 who survived to the landmark, had clinically indicated pre-landmark echocardiographic LVEF assessment, and had calculable early PNI. The prespecified primary analysis tested the lower-PNI-by-LVEF-defined-SCM interaction for 28-day mortality in an adjusted Cox model. Ninety-day and sensitivity analyses were supportive or exploratory. A single-center cohort was examined separately, not as formal validation. Among 1,976 patients, 240 had LVEF-defined SCM; 506 and 633 died by 28 and 90 days, respectively. Each 5-point lower PNI was associated with higher 28-day mortality without SCM (adjusted hazard ratio [HR], 1.18; 95% CI, 1.11-1.24) but not with LVEF-defined SCM (HR, 0.96; 95% CI, 0.87-1.05); the ratio of HRs was 0.82 (95% CI, 0.73-0.91; p < 0.001). The secondary 90-day ratio was 0.84 (95% CI, 0.76-0.94; nominal p = 0.001). Absolute-risk and restricted-mean-survival-time analyses supported attenuation, whereas same-calendar-day PNI pairing and some alternative LVEF definitions attenuated the interaction estimates toward the null. The external estimate was imprecise and statistically inconclusive (ratio of odds ratios, 0.89; 95% CI, 0.51-1.55). Among selected 72-h survivors with clinically indicated pre-landmark echocardiography, the association between lower PNI and 28-day mortality was attenuated with LVEF-defined SCM. PNI should not be used alone for nutritional or clinical decision-making.

PMID 42903086
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