Effect of fenofibrate on indirect neonatal hyperbilirubinemia

Abstract

Background: Neonatal jaundice is a cause for anxiety in parents as well as physicians due to its complications and prolonged hospital stay with increased cost. With early discharge practice, neonatal hyperbilirubinemia has become an important cause for readmission. Aim: The aim of this study is to evaluate the efficacy of oral fenofibrate in the treatment of neonatal hyperbilirubinemia in full term (FT) neonates due to ABO or Rh incompatibility. Design: The type of the study is prospective case control study. Patients and Methods: This study was carried out on 60 FT newborns suffering from neonatal hyperbilirubinemia due to ABO or Rh incompatibility and exaggerated physiological jaundice divided into two groups. Group A (control group): This group included 30 FT neonates with neonatal hyperbilirubinemia 19 males and 11 females. Their duration of stay ranged from 4 to 7 days. All the neonates in this group received phototherapy only. Group B (fenofibrate group): This group included 30 FT neonates with neonatal hyperbilirubinemia 20 males and 10 females. Their postnatal age ranged from day 1 to day 6. Their duration of stay ranged from 4 to 7 days. All the neonates in this group received one single oral dose of fenofibrate suspension with a dose 10 mg/kg beside phototherapy. Results: In our study, there was a statistically significant difference between the two groups (fenofibrate group vs. control group) as regard the response of babies to decrease the level of total serum bilirubin (TSB) and the duration of stay on phototherapy in hospital lower in fenofibrate group. We found that babies in fenofibrate group showed lower values in successive TSB levels and lower duration of stay in comparison to the control group. We studied the highest level of TSB reached during treatment and found that mean TSB of fenofibrate group was 15.797 mg/dl while mean TSB of the control group was 16.593 mg/dl. In our study, we found that the mean duration of stay at the hospital of fenofibrate group was 4.366 days, while mean duration of stay at the hospital of the control group was 5.633 days (P = 0.0058*). Conclusion: The use of a single oral dose of fenofibrate (with a dose 10 mg/kg) with phototherapy accelerates bilirubin conjugation and excretion via induction of glucuronyl transferase activity hence reduces the duration of stay in hospital.