Evaluating the effects of different doses of ursodeoxycholic acid on neonatal jaundice

Abstract

Background. Icterus tends to be one of the most prevalent causes of neonatal hospitalization. The present study aimed to evaluate the effects of the different doses of ursodeoxycholic acid (UDCA) on neonatal jaundice. Method. In this study, 120 newborns who were hospitalized for phototherapy were randomly assigned. Group A received phototherapy and UDCA 5 mg/kg/dose every 12 hours orally, group B patients were treated with phototherapy and UDCA 7.5 mg/kg/dose every 12 hours orally. Group C received phototherapy with a placebo. All patients were evaluated for bilirubin levels, the duration of phototherapy, and the length of hospital stay. Results. The mean bilirubin level at hospital admission was 19.88 ± 2.33 mg/dl in group A, 19.33 ± 2.51 mg/ dl in group B, and 19.76 ± 2.64 mg/dl in group C (p= 0.58). The groups receiving phototherapy with UDCA showed a significant decrease in the bilirubin level. Bilirubin level decreased to 10.04 ± 1.11mg/dl in group A, 8.82 ± 1.11 mg/dl in group B, and 12.04 ± 2.05 mg/dl in group C (p= 0.000). Furthermore, the mean duration of phototherapy, as well as the average length of hospital stay, were significantly lower in group B as compared to the other groups (p= 0.000). Conclusion. The findings of this study indicated that the administration of UDCA in addition to phototherapy could effectively decrease the length of hospital stay and bilirubin levels in neonatal hyperbilirubinemia. However, further studies with a larger sample size are required before one can recommend the routine use of UDCA for the treatment of neonatal jaundice.

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

“…We did not perform any subgroup analysis based on the different doses as it was not preplanned. We observed that the studies with a higher dose [ 19 , 21 ] showed similar results compared to the studies using smaller doses of UDCA. The optimal dose with the best benefit/harm ratio remains to be determined as majority of the studies included in this meta-analysis did not report any adverse effects.…”

“…The limitations of this review are largely those of the primary studies. As four of the studies were not placebo-controlled [ 17 – 21 ] and one of these did not comment on the blinding at all [ 17 ], the results presented here are vulnerable to bias. Furthermore, only one of the included studies reported adverse outcomes [ 22 ], and none of the studies reported rehospitalization rates.…”

“…In addition, the population characteristics were reported incompletely, which limits the generalizability of the results. Two studies did not state the cutoff bilirubin level to stop phototherapy [ 20 , 21 ]. All the included studies were conducted in relatively small geographical areas (Iran [ 17 – 19 , 21 , 22 ] and Egypt [ 20 ]).…”

“…UDCA is generally well tolerated [ 27 ]. UDCA was reported to be effective in reducing the duration of phototherapy in healthy term neonates [ 17 – 21 ], in sick neonates [ 23 ] and among neonates with G6PD deficiency [ 24 ]. One previous study found no additional value of combining UDCA with standard phototherapy [ 22 ].…”

The effects of clofibrate on neonatal jaundice: A systematic review

“…On the other hand, there is limited strong evidence about the use of pharmacotherapy such as clofibrate, human albumin, intravenous immunoglobulin, herbal therapy, ursodeoxycholic acid, and phenobarbital treatment in neonatal jaundice. [ 12 18 19 20 21 ] Clofibrate is an aryloxyisobutyric acid derivative used in the treatment of hypertriglyceridemia and dyslipidemia. [ 13 ] However, previous studies showed that clofibrate is effective in the treatment of neonatal jaundice.…”