# A randomised controlled trial comparing epinephrine and dexamethasone to placebo in the treatment of infants with bronchiolitis (BIPED study): a statistical analysis plan

**Authors:** Anna Heath, David Rios, Kristina I. Vogel, Tremaine Rowe, Natasha Wills-Ibarra, Ed Oakley, Martin Offringa, Petros Pechlivanoglou, Terry P. Klassen, Stuart R. Dalziel, Amy C. Plint, Eleanor Pullenayegum, Eleanor Pullenayegum, Jeff Round, Andy Willan, Garth Meckler, Mark Roback, Anupam Kharbanda, Eyal Cohen, Lise Nigrovic

PMC · DOI: 10.1186/s13063-025-09125-w · Trials · 2025-11-12

## TL;DR

This study aims to determine if a combination of epinephrine and dexamethasone reduces hospitalization in infants with bronchiolitis.

## Contribution

The study introduces a novel combination therapy of epinephrine and dexamethasone for treating bronchiolitis in infants.

## Key findings

- The BIPED study will evaluate if the drug combination reduces hospitalization rates for bronchiolitis.
- Secondary outcomes include healthcare costs and safety outcomes like gastrointestinal bleeding and serious infections.
- The statistical analysis plan is designed to minimize bias in reporting outcomes.

## Abstract

Bronchiolitis is a common lung infection that affects infants and young children. While most children can be treated at home, some require hospitalisation where supportive care, such as fluids and oxygen, is the suggested treatment. Bronchiolitis is the leading cause of infant hospitalisation in developed countries and exerts a significant burden on the healthcare system. The aim of the Bronchiolitis in Infants Placebo Versus Epinephrine and Dexamethasone (BIPED) study is to evaluate the effects of a combination of epinephrine and dexamethasone, given during initial presentation at the emergency department, on hospitalisation for bronchiolitis. This article outlines the statistical analysis plan (SAP) for the BIPED study.

The BIPED study is a Phase III, multi-centre, randomised, controlled, double-blinded superiority, placebo-controlled trial to determine whether the combination of epinephrine and dexamethasone is successful in reducing hospitalisation for bronchiolitis up to 7 days following presentation at an emergency department with bronchiolitis. The secondary outcomes include hospital admissions for bronchiolitis at the emergency department enrolment visit, and all-cause hospital admissions, health care provider visits and health care-related costs in the 21 days following enrolment. The safety outcomes are gastrointestinal bleeding, serious bacterial infection, severe varicella and death.

The BIPED study will provide evidence on whether a combination of epinephrine and dexamethasone reduces hospitalisation in infants following presentation to the emergency department with bronchiolitis. These data will be analyzed using this SAP, submitted before the data became available for analysis, to reduce the risk of bias in our reported outcomes.

ClinicalTrials.gov NCT03567473. Registered on June 25, 2018.

## Linked entities

- **Chemicals:** epinephrine (PubChem CID 838), dexamethasone (PubChem CID 5743)
- **Diseases:** bronchiolitis (MONDO:0002465)

## Full-text entities

- **Diseases:** lung infection (MESH:D012141), varicella (MESH:D002644), Bronchiolitis (MESH:D001988), bacterial infection (MESH:D001424), death (MESH:D003643), gastrointestinal bleeding (MESH:D006471), emergency (MESH:D004630)
- **Chemicals:** BIPED (-), Dexamethasone (MESH:D003907), Epinephrine (MESH:D004837), oxygen (MESH:D010100)

## Full text

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## References

8 references — full list in the complete paper: https://tomesphere.com/paper/PMC12613535/full.md

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Source: https://tomesphere.com/paper/PMC12613535