Role of ursodeoxycholic acid in neonatal indirect hyperbilirubinemia: a systematic review and meta-analysis of randomized controlled trials

Abstract

Background Neonatal jaundice is a transitional phenomenon affecting three out of five full-term newborns globally. Ursodeoxycholic acid could be beneficial in neonatal jaundice needing phototherapy. Methods We searched PubMed, EBSCO, ProQuest, and Cochrane Library up to August 21st, 2021, for articles to be reviewed. Meta-analysis using random-effects model was performed. Results Eight studies involving 1116 neonates were chosen in this review; however, only five studies were included for meta-analysis. Phototherapy duration was significantly lower in the interventional group with high heterogeneities. Subgroup analysis of the phototherapy duration based on the risk of bias resulted in a shorter duration (mean difference (MD) = –17.82; 95% CI = –20.17 to –15.47; p = < 0.001) with low heterogeneity in the treatment group. Secondary outcome focusing on mean total serum bilirubin showed a lower mean total serum bilirubin in 48 h post-treatment (MD = –0.43; 95% CI = –0.64 to –0.22; p = < 0.0001) with low heterogeneities in Asian countries.” Conclusions Ursodeoxycholic acid might be considered as a novel adjuvant therapy in neonatal indirect hyperbilirubinemia to shorten the phototherapy duration and lower the mean total serum bilirubin.

Effect of Ursodeoxycholic Acid in Unconjugated Hyperbilirubinemia in the Term Neonates Treated with Phototherapy: A Systematic Review

“…Instead, a recent meta-analysis by Lazarus et al concluded that UDCA with PT was effective in reducing the Pt duration and reducing the TSB levels. 36 There are several hypotheses related to how UDCA may reduce the UCB. For example, Cuperus et al 37 on the enterohepatic recirculation of UCB and increased fecal secretion.…”

Rationale, completeness and quality of evidence for the use of ursodeoxycholic acid in neonatal hyperbilirubinemia

“…Полнота систематических обзоров определялась наличием среди всех включенных в обзор исследований всех идентифицированных в рамках текущего проекта исследований [13]. Обзор признан полным, если все идентифицированные, подходящие и опубликованные Характеристика систематических обзоров Обзоры выполнены авторами из Финляндии (Kuitunen I. и соавт., 2022) [16 ], Италии (Lazarus G. и соавт., 2022) [17 ], Саудовской Аравии (Huseynova R.A., 2022) [18 ] и Китая (Wang G. и соавт., 2023) [19 ]. Во всех обзорах оценено влияние УДХК в сочетании с фототерапией на уровень общего сывороточного билирубина, продолжительность фототерапии и частоту нежелательных явлений в сравнении с фототерапией ± плацебо при гипербилирубинемии у доношенных [17 , 18] или доношенных и поздних недоношенных детей [16 , 19] без факторов риска.…”

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

“…A meta-analysis evaluates, in case of neonatal indirect hyperbilirubinemia in treatment with phototherapy, the use of ursodeoxycholic acid as adjunctive therapy [140]. Ursodeoxycholic acid is classically used for the management of cholestatic liver pathology through increased production of bile, the removal of the most toxic components of bile acids and additional hepatoprotective and neuroprotective effects [141][142][143].…”