Aly 2007.

Methods	Single centre, randomised controlled trial conducted in Cairo, Egypt. Study period: not stated
Participants	21 preterm infants (< 35 weeks' gestation) aged 2 to 7 days with respiratory distress and PDA diagnosed by Doppler ECHO Ibuprofen (oral): 12 infants, mean (SD) GA 31.2 (2.5) weeks; BW 1521 (398) grams; 8 boys, 4 girls Indomethacin (IV): 9 infants, mean (SD) GA 32.9 (1.6) weeks; BW 1884 (485) grams; 4 boys, 5 girls
Interventions	Ibuprofen: initial oral dose of 10 mg/kg, followed by 2 doses orally of 5 mg/kg after 24 and 48 hours Indomethacin: IV as 3 doses of 0.2 mg/kg at 12‐hour intervals
Outcomes	Primary outcome: ductal closure Secondary outcomes: biochemical tests (serum creatinine), pulmonary haemorrhage, gastrointestinal bleed, NEC, gastrointestinal perforation, and increase in serum creatinine following treatment
Notes	No information about funding of the study
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No description provided
Allocation concealment (selection bias)	Low risk	Sealed opaque envelopes were used for random assignment
Blinding of participants and personnel (performance bias) All outcomes	High risk	Ibuprofen was given orally, whereas indomethacin was given IV. Ibuprofen and indomethacin were given at different time points
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Ibuprofen was given orally, whereas indomethacin was given IV. Ibuprofen and indomethacin were given at different time points. ECHOs were performed by an experienced paediatric cardiologist, and it is stated that he was blinded to the treatments
Incomplete outcome data (attrition bias) All outcomes	Low risk	Outcomes reported for all randomised infants
Selective reporting (reporting bias)	Unclear risk	Study protocol was not available to us so we could not ascertain if there were deviations from the protocol
Other bias	Low risk	Appeared free of other bias