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Clofibrate for unconjugated hyperbilirubinemia in neonates: A systematic review

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Abstract

Objective

To evaluate the effect of clofibrate for unconjugated hyperbilirubinemia in neonates.

Methods

A systematic review with meta-analysis of randomized controlled trials or quasi-randomized controlled trials was conducted to evaluate the clofibrate treatment in neonates with unconjugated hyperbilirubinemia. We followed the guidelines from the Cochrane review group and the PRISMA statement.

Results

Of 148 studies identified, a total of 13 studies on 867 infants were included. A single oral administration of clofibrate was associated with decreased need of phototherapy (RR:.38, 95% CI: 0.21 to 0.68), shortened duration of phototherapy (mean duration: 23.88 h, 95% CI: 33.03 to −14.72 h) and reduced peak total serum bilirubin (mean duration: −1.62 mg/dL, 95% CI: 2.13 to −1.11 mg/dL). These effects were especially obvious in term infants and infants without hemolytic diseases. Data regarding mortality or kernicterus were not available from included studies.

Conclusions

Clofibrate may have short-term benefits for the infants with hyperbilirubinaemia, especially for population of term infants and infants without hemolytic diseases. Large RCTs with long-term followup are required to verify the safety of clofibrate and assess its long-term effects.

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References

  1. Rennie J, Burman-Roy S, Murphy MS. Neonatal jaundice: summary of NICE guidance. BMJ. 2010;340:c2409.

    Article  PubMed  Google Scholar 

  2. Suresh GK, Martin CL, Soll RF. Metalloporphyrins for treatment of unconjugated hyperbilirubinemia in neonates. Cochrane Database Syst Rev. 2003:CD004207.

  3. Steiner LA, Bizzarro MJ, Ehrenkranz RA, Gallagher PG. A decline in the frequency of neonatal exchange transfusions and its effect on exchange-related morbidity and mortality. Pediatrics. 2007;120:27–32.

    Article  PubMed  Google Scholar 

  4. Alcock GS, Liley H. Immunoglobulin infusion for isoimmune haemolytic jaundice in neonates. Cochrane Database Syst Rev. 2002:CD003313.

  5. Cuperus FJ, Hafkamp AM, Hulzebos CV, Verkade HJ. Pharmacological therapies for unconjugated hyperbilirubinemia. Curr Pharm Dis. 2009;15:2927–2938.

    Article  CAS  Google Scholar 

  6. Wang G, Shen H, Rajaraman G, Roberts MS, Gong Y, Jiang P, et al. Expression and antioxidant function of liver fatty acid binding protein in normal and bile-duct ligated rats. Eur J Pharmacol. 2007;560:61–68.

    Article  PubMed  CAS  Google Scholar 

  7. Lindenbaum A, Hernandorena X, Vial M, Benattar C, Janaud JC, Dehan M, et al. Clofibrate for the treatment of hyperbilirubinemia in neonates born at term: a double blind controlled study (author’s transl). Arch Fr Pediatr. 1981;38:867–873. (Article in French).

    PubMed  Google Scholar 

  8. Cochrane Neonatal Review Group. Guidelines for Reviewers and Editors Available from: http://neonatalcochraneorg. Accessed October 1, 2010.

  9. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–560.

    Article  PubMed  Google Scholar 

  10. Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959;22:719–748.

    PubMed  CAS  Google Scholar 

  11. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–188.

    Article  PubMed  CAS  Google Scholar 

  12. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–634.

    Article  PubMed  CAS  Google Scholar 

  13. Lindenbaum A, Delaporte B, Benattar C, Dehan M, Magny JF, Gerbet D, et al. Preventive treatment of jaundice in premature newborn infants with clofibrate. Double-blind controlled therapeutic trial. Arch Fr Pediatr. 1985;42:759–763. (Article in French).

    PubMed  CAS  Google Scholar 

  14. Flores Nava G, Vargas Perez C, Lopez Padilla M, Escobedo Chavez E. Clofibrate in the prevention of neonatal hyperbilirubinemia. Practica Pediatrica. 1996;5:40–46.

    Google Scholar 

  15. Mohammadzadeh A, Farhat A, Iranpour R. Effect of clofibrate in jaundiced term newborns. Indian J Pediatr. 2005;72:123–126.

    Article  PubMed  Google Scholar 

  16. Moslehi MA, Pishva N. Determination of effect of low dose vs moderate dose clofibrate on decreasing serum bilirubin in healthy term neonates. Iranian Journal of Pediatrics. 2007;17:108–112.

    Google Scholar 

  17. Eghbalian F, Pourhossein A, Zandevakili H. Effect of clofibrate in non-hemolytic indirect hyperbiliru-binemia in full term neonates. Indian J Pediatr. 2007;74:1003–1006.

    Article  PubMed  Google Scholar 

  18. Zahedpasha Y, Ahmadpour-Kacho M, Hajiahmadi M, Naderi S. Effect of clofibrate in jaundiced full-term infants:a randomized clinical trial. Arch Iran Med. 2007;10:349–353.

    PubMed  CAS  Google Scholar 

  19. Badeli H, Sharafi R, Sajedi S. The effect of clofibrate on neonatal hyperbilirubinemia in uncomplicated jaundice. Iranian Journal of Pediatrics. 2008;18:20–24.

    Google Scholar 

  20. Mohammadzadeh A, Farhat A, Jafarzadeh M, Mirzarahimi M, Esmaili H, Amiri R. Prophylactic effect of clofibrate in low birth weight neonates, hyperbilirubinemia. J Chinese Clinical Med. 2008;3:140–144.

    CAS  Google Scholar 

  21. Zahedpasha Y, Ahmadpour-Kacho M, Hajiahmadi M, Naderi S, Kamali AA. Efficacy of clofibrate on severe neonatal jaundice associated with glucose-6-phosphate dehydrogenase deficiency (a randomized clinical trial). Southeast Asian J Trop Med Public Health. 2008;39:557–561.

    PubMed  Google Scholar 

  22. Mohammadzadeh A, Farhat AS, Amiri R, Esmaely H, Bagheri S. Treatment effect of clofibrate in jaundiced low birth weight neonates. International J Hematol Oncol. 2009;19:100–105.

    CAS  Google Scholar 

  23. Sakha SH, Gharehbaghi MM, Rahbani ME. The effect of clofibrate with phototherapy in late pre-term newborns with non-hemolytic jaundice. Indian J Med Sci. 2009;63:174–179.

    Article  PubMed  Google Scholar 

  24. Sharafi R, Mortazavi Z, Sharafi S, Parashkouh R. The effect of clofibrate on decreasing serum bilirubin in healthy term neonates under home phototherapy. Iran J Pediatr. 2010;20:48–52.

    Google Scholar 

  25. Penna F, Bonelli G, Baccino FM, Costelli P. Cytotoxic properties of clofibrate and other peroxisome proliferators: relevance to cancer progression. Curr Med Chem. 2010;17:309–320.

    Article  PubMed  CAS  Google Scholar 

  26. Loomba RS, Arora R. Prevention of cardiovascular disease utilizing fibrates—a pooled meta-analysis. Am J Ther. 2010;17:e182–e188.

    Article  PubMed  Google Scholar 

  27. Fidaleo M. Human health risk assessment for peroxisome proliferators: more than 30 years of research. Exp Toxicol Pathol. 2009;61:215–221.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China

    Tao Xiong, Dapeng Chen, Zhoujin Duan & Yi Qu

  2. Department of Neurology and Pediatrics, Newborn Brain Research Institute, University of California, San Francisco, California, USA

    Dezhi Mu

  3. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

    Dezhi Mu

Authors
  1. Tao Xiong
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  2. Dapeng Chen
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  3. Zhoujin Duan
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  4. Yi Qu
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  5. Dezhi Mu
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Correspondence to Dezhi Mu.

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Xiong, T., Chen, D., Duan, Z. et al. Clofibrate for unconjugated hyperbilirubinemia in neonates: A systematic review . Indian Pediatr 49, 35–41 (2012). https://doi.org/10.1007/s13312-012-0012-x

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  • DOI: https://doi.org/10.1007/s13312-012-0012-x

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