The Effect of Clofibrate on Hyperbilirubinemia of Term Neonates
Clofibrate is a glucuronosyl transferase inducer that has been proposed to increase the elimination of bilirubin in neonates with hyperbilirubinemia. This study was conducted to determine the therapeutic effect of clofibrate in term neonates with non-hemolytic jaundice. This study was conducted on 52 newborns with pathologic unconjugated jaundice in Qazvin children hospital. Newborns divided randomly in two groups. Case group treated with clofibrate and intensive phototherapy, while control group treated only with intensive phototherapy. Serum bilirubin level was measured before and 6, 12, 24 and 48 hours after treatment. Results were compared and analyzed. The mean serum level of bilirubin before treatment in the case and control groups were 20.78±2.38 and 20.52 ±2.44 mg/dl, respectively (P=0.69). The mean serum level of bilirubin in 6, 12, 24 and 48 hours after treatment in the case group were 18.20±2.20, 14.70±2.06, 10.72±2.40 and 8.90±0.83 mg/dl , respectively. These values in control group were 18.26±2.42, 15.36±2.59, 12.29±2.28 and 10.23±1.50 mg/dl, respectively. There was significant difference between two groups regarding mean serum level of bilirubin 24 hours (P=0.019) and 48 hours after treatment (P=0.005). In conclusion, clofibrate was effective in reducing neonatal jaundice and its effect appeared 24 hours after treatment.
Alcock GS, Liley H. Immunoglobulin infusion for isoimmunehaemolytic jaundice in neonates.Cochrane Database Syst Rev2002;(3):CD003313.
Bhutani VK, Johnson L.Kernicterus in the 21st century: frequently asked questions. J Perinatol 2009;29Suppl 1:S20-4.
Brun S, Carmona MC, Mampel T, Viñas O, Giralt M, Iglesias R, Villarroya F.Activators of peroxisome proliferator-activated receptor-alpha induce the expression of the uncoupling protein-3 gene in skeletal muscle: a potential mechanism for the lipid intake-dependent activation of uncoupling protein-3 gene expression at birth.Diabetes 1999;48(6):1217-22.
Cuperus FJ, HafkampAM, Hulzebos CV, Verkade HJ. Pharmacological therapies for unconjugated hyperbilirubinemia.Curr Pharm Des 2009;15(25):2927-38.
Dennery PA.Pharmacological interventions for the treatment of neonatal jaundice.SeminNeonatol 2002;7(2):111-9.
Eghbalian F, Pourhossein A, Zandevakili H.Effect of clofibrate in non-hemolytic indirect hyperbiliru-binemia in full term neonates.Indian J Pediatr 2007;74(11):1003-6.
Erkul I, Yavuz H, Ozel A.Clofibrate treatment of neonataljaundice.Pediatrics1991;88(6):1292-4.
Gabilan JC.Pharmacologic treatment of neonatal jaundice. A new approach. Arch Pediatr1998;5(11):1274-8.
Gabilan JC, Benattar C, Lindenbaum A.Clofibrate treatment of neonatal jaundice.Pediatrics 1990;86(4):647-8.
Kutz K, Kandler H, Gugler R, Fevery J.Effect of clofibrate on the metabolism of bilirubin, bromosulphophthalein and indocyanine green and on the biliary lipid composition in Gilbert's syndrome.ClinSci (Lond)1984;66(4):389-97.
Ho NK.Traditional Chinese medicine and treatment of neonatal jaundice.Singapore Med J 1996;37(6):645-51.
Madan A, MacMahon JR, Stevenson DK. Neonatalhyperbilirubinaemia. In: Taeusch HW, Ballard RA, Gleason CA, editors. Avery's Disease of the Newborn. 8th ed. Philadelphia, PA: Elsevier Saunders; 2005. p. 1226-53.
Maisels MJ. Neonatal hyperbilirubinemia and kernicterus - not gone but sometimes forgotten. Early Hum Dev2009;85(11):727-32.
Mohammadzadeh A, FarhatASh, Iranpour R. Effect of clofibrate in jaundiced term newborns. Indian J Pediatr 2005;72(2):123-6.
Piazza AJ, Stoll BJ. Jaundice and hyperbilirobinemia in the newborn. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson Textbook of Pediatrics.18th ed. Philadelphia, Pa: Saunders Elsevier; 2007. p. 756-65.
Rubaltelli FF.Current drug treatment options in neonatalhyperbilirubinaemia and the prevention of kernicterus.Drugs 1998;56(1):23-30.
Sakha SH, Gharehbaghi MM, Rahbani ME. The effect of clofibrate with phototherapy in late pre-term newborns with non-hemolytic jaundice. Indian J Med Sci2009;63(5):174-9.
Sharafi R, Mortazavi Z, SharafiS, Moradi Parashkouh R.The effect of clofibrate on decreasing serum Bilirubin in healthy term neonates under home phototherapy. Iran J Pediatr 2010;20(1):48-52.
Schwoebel A, Gennaro S. Neonatal hyperbilirubinemia. J Perinat Neonatal Nurs 2006;20(1):103-7.
Sweetman SC. Martindale: The Complete Drug Reference. 33rd ed. London, UK: The Pharmaceutical Press; 2002. p. 859-60.
Wazir S, Angiti RR, Kumar P.Effect of clofibrate in jaundiced term neonates.Indian J Pediatr2006;73(2):170; author reply 171.
Wong RJ, DeSandre GH, Sibley L, StevensonDK. Neonatal jaundice and liver disease. In: Martin RJ,Fanaroff AA,Walsh MC, editors.Fanaroff and Martin's Neonatal- Perinatal Medicine: Diseases of the Fetus and Infant. 8th ed. Philadelphia, PA: Mosby Elsevier; 2006. p. 1419-65.
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(3):557-61.
Zahedpasha Y, Ahmadpour-Kacho M, Hajiahmadi M, Naderi S.Effect of clofibrate in jaundiced full-term infants:a randomized clinical trial.Arch Iran Med2007;10(3):349-53.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.