Effect of Ursodeoxycholic Acid on Indirect Hyperbilirubinemia in Neonates Treated With Phototherapy

Honar, Naser; Saadi, Elham Ghashghaei; Saki, Fatemeh; Pishva, Narjes; Shakibazad, Nader; Teshnizi, Saeed Hosseini

doi:10.1097/mpg.0000000000000874

Cited by 23 publications

(58 citation statements)

References 11 publications

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“…We found only two similar studies concerning with the effects of UDCA in neonatal indirect hyperbilirubinemia. In one study, Honar et al who enrolled 40 neonates with indirect hyperbilirubinemia treated with 10 mg/dl UDCA daily [12]. The researchers reported that UDCA in combination with phototherapy was more effective than phototherapy alone in lowering total bilirubin level at 12, 24, and 48 hours after therapy [12].…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Effects of Ursodeoxycholic Acid in Neonatal Indirect Hyperbilirubinemia; a Randomized Double-Blind Clinical Trial

Shahramian

Tabrizian

Ostadrahimi

et al. 2019

AACC

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Background: Ursodeoxycholic acid (UDCA) is a safe drug used in the treatment of cholestatic liver disorders in children. The aim of this study was to investigate the synergistic effect of UDCA in combination with phototherapy in treating indirect neonatal hyperbilirubinemia. Methods: Present double-blinded, randomized clinical trial was conducted among neonates with jaundice who were under treatment with phototherapy in the neonatal ward affiliated with the Zabol University of Medical Sciences in 2017. The patients (200 neonates) were randomly divided into intervention (phototherapy+ UDCA) and control (phototherapy alone) groups. The intervention group received 15 mg/kg UDCA daily. Results: Total bilirubin levels at birth, 24, 48, and 72 hours after therapy were 16.89± 2.49, 14.28± 2.05, 11.62± 2.46, and 10.26± 1.92 mg/dl in controls and 15.79± 2.18, 12.77± 1.86, 10.08± 1.66, and 8.94± 1.38 mg/dl in intervention group respectively (P< 0.001). The ratio of neonates with total bilirubin< 10 mg/dl were 28% and 55% after 48 hours, and 64% and 90% after 72 hours of therapy initiation in phototherapy alone and phototherapy+ UDCA groups respectively (P< 0.001). The mean reduction of direct bilirubin was not significantly different between the groups. Conclusion: UDCA was effective in accelerating reduction of total bilirubin level in neonates with unconjugated hyperbilirubinemia under phototherapy but had no effect on direct bilirubin levels.

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Section: Discussionmentioning

confidence: 99%

Therapeutic Effects of Ursodeoxycholic Acid in Neonatal Indirect Hyperbilirubinemia; a Randomized Double-Blind Clinical Trial

Shahramian

Tabrizian

Ostadrahimi

et al. 2019

AACC

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“…10,11 Similar to present study, Hassan et al and Honar also did not report any side effect of UDCA treatment. 12,4 However, there was some limitation in the present study as we were not able to predict all the variables which have a role in indirect hyperbilirubinemia. Further studies need to evaluate the efficacy of UDCA in the treatment of UCB of neonates.…”

Section: Discussionmentioning

confidence: 77%

“…However, it is expensive and disrupts mother child bonding. 4 Can also lead to potential complications like retinal degenerative changes, bronze baby syndrome, and thermal instability.¹ Therefore, adjuvant therapies like phenobarbital, metalloporphyrin, clofibrate and bile salts that decrease the duration of phototherapy are being looked into. 1 Ursodeoxycholic acid is a bile acid widely used in the treatment of cholestatic liver disorders.…”

Section: Introductionmentioning

confidence: 99%

“…1 Ursodeoxycholic acid is a bile acid widely used in the treatment of cholestatic liver disorders. 4 Few studies have been conducted using UDCA in indirect hyperbilirubinemia. The usual dose in neonates is 10-20 mg /kg day.…”

Section: Introductionmentioning

confidence: 99%

“…5 It prevents the liver against oxidative stress, prevents cellular apoptosis and stimulates bile flow. 4 Therefore, we planned this study to know the role of Ursodeoxycholic acid on indirect hyperbilirubinemia in neonates…”

Section: Introductionmentioning

confidence: 99%

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Role of ursodeoxycholic acid in neonates with indirect hyperbilirubinemia-an open labelled randomised control trial

Jafari¹,

Khan²,

Bhatnagar³

et al. 2018

Int J Contemp Pediatr

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Background: Ursodeoxycholic Acid (UDCA) is a bile acid widely used in the treatment of cholestatic liver disorders. Few studies have been conducted using UDCA in indirect hyperbilirubinemia. We planned this study to know the role of Ursodeoxycholic acid on indirect hyperbilirubinemia in neonatesMethods: The study was conducted in Department of Paediatrics and Neonatology at Eras Lucknow Medical College and Hospital from November 2015 to September 2017 in 96 term neonates with total bilirubin levels in phototherapy range. They were randomized into 3 Groups receiving either phototherapy only or UDCA at 10mg/kg/day or 20mg/kg/day along with phototherapy.Results: Present study showed that there was a higher rate of fall and less duration of phototherapy required in children receiving UDCA. However, there was no difference in the group receiving 10mg vs 20 mg /kg/day Conclusions: We conclude that by giving UDCA at 10mg/kg/day along with phototherapy in neonate with indirect hyperbilirubinemia leads to faster resolution of hyperbilirubinemia.

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Ursodeoxycholic acid as adjuvant treatment to phototherapy for neonatal hyperbilirubinemia: a systematic review and meta-analysis

et al. 2022

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Background Neonatal hyperbilirubinemia is observed in most newborns, and 5–15% of neonates require phototherapy. Phototherapy is effective but often prolongs hospitalization and has both short-term and potential long-term harms. The aim of this systematic review and meta-analysis was to evaluate the role of ursodeoxycholic acid (UDCA) combined with phototherapy in neonatal hyperbilirubinemia. Methods A literature search was conducted on September 1, 2021; 590 studies were screened, and 17 full texts were assessed by two authors. We included randomized controlled trials with or without placebo intervention. Primary outcomes were changes in total bilirubin levels at 24 hours and phototherapy duration. We calculated mean differences with 95% confidence intervals (CI). Results Six studies with 880 neonates were included. Of these studies, only two used a placebo-controlled double-blinded design. The overall risk of bias was high in one and moderate in four of the included studies. The mean decrease in the total bilirubin level during the first 24 hours was 2.06 mg/dL (95% CI 0.82–3.30; six studies) greater in the UDCA treatment group. The phototherapy duration was 19.7 hours (95% CI 10.4–29.1; five studies) shorter in the UDCA treatment group. Conclusions We found low-quality evidence that UDCA as an adjuvant to phototherapy seems to decrease total bilirubin faster and shorten phototherapy duration compared to standard treatment. Further studies are needed to confirm the efficacy, acute and long-term outcomes, and safety before implementing UDCA as an adjuvant to phototherapy in neonatal hyperbilirubinemia.

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Effect of Ursodeoxycholic Acid on Indirect Hyperbilirubinemia in Neonates Treated With Phototherapy

Abstract: Ursodeoxycholic acid had additive effect with phototherapy in neonates with indirect hyperbilirubinemia. This drug also reduced the time period needed for phototherapy and, consequently, decreased the hospitalization period.

Cited by 23 publications

References 11 publications

Therapeutic Effects of Ursodeoxycholic Acid in Neonatal Indirect Hyperbilirubinemia; a Randomized Double-Blind Clinical Trial

Therapeutic Effects of Ursodeoxycholic Acid in Neonatal Indirect Hyperbilirubinemia; a Randomized Double-Blind Clinical Trial

Role of ursodeoxycholic acid in neonates with indirect hyperbilirubinemia-an open labelled randomised control trial

Ursodeoxycholic acid as adjuvant treatment to phototherapy for neonatal hyperbilirubinemia: a systematic review and meta-analysis

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