The effect of ursodeoxycholic acid on indirect hyperbilirubinemia in neonates treated with phototherapy: a randomized clinical trial

Akefi, Rona; Hashemi, Mojtaba; Alinejad, Saeed; Almasi‐Hashiani, Amir

doi:10.1080/14767058.2020.1846705

Cited by 10 publications

(32 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The time specified in our study for "with phototherapy and phototherapy" (three hours for the continuous group with 45 mints lapse, 3 hours for the intermittent group, 3 hours for the rest) could reduce enterohepatic bilirubin circulation (permitting additional spell for nursing in the intermittent group), which resulted in huge decline in serum level of bilirubin in comparison to the Niknafs et al study which used "two hours on, half an hour off" and "one hour off" in the CPT group and one hour on with one hour off, in the IPT group [15][16] . The phototherapy duration in the IPT group was shorter than in the continuous phototherapy group, as Monica et al [17][18] .…”

Section: Discussionmentioning

confidence: 75%

Comparison of Intermittent vs. Continuous Phototherapy in the treatment of Non-Haemolytic Neonatal Hyperbilirubinemia

Ullah¹,

Khan²,

Kazemi³

et al. 2022

PJMHS

View full text Add to dashboard Cite

Introduction: Phototherapy is used in the treatment of hyperbilirubinemia in initial life-span of neonates. Our objective was the comparison of continuous vs intermittent phototherapy in the reduction of total serum bilirubin, bilirubin decrease rate, phototherapy time and hospital stay in non-haemolytic hyperbilirubinemia neonates. Place and Duration: The study was conducted at department of Pediatric medicine in Qazi Hussain Ahmad Medical Complex, Nowshera for the duration of six months from 16th January 2021 to 15th July 2021. Methods: The study involved 160 neonates with birth weight ≥2000 gm and age was above 34 weeks. They were randomly assigned to group A who were given continuous phototherapy for 3hrs and 50 mints and then rest for 45mints and group B who were given intermittent phototherapy for 3 hours and then rest for next 3 hours and so on. The levels of TSB were calculated in both groups and their comparison was made at every 12, 24 and 48 hrs after the start of phototherapy. Results: The mean of total serum bilirubin on admission was 16.01 ± 3.91 mg / dL for the continuous group and 15.21 ± 1.12 mg / dL for the intermittent group. The TSB mean after 12, 24 and 48 hrs. for continuous phototherapy was 13.30 ± 2.3 mg / dl, 11.1 ± 2.01 mg / dl, 9.26 ± 0.92 mg / dl and 13.1 ± 1.70 mg / dL, 9.54 ± 1.7 mg / dL, 8.9 ± 0.61 mg / dl (p <0.05) for the intermittent group, respectively. The mean rate of decrease in serum concentration of bilirubin was 0.30 ± 0.14 mg / dl / h in group A and 0.19 ± 0.07 mg / dl / h in group B (p = 0.5). There was no big variance between the mean hospital stay in groups A and B (p = 0.550). Conclusions: Intermittent phototherapy is a better choice than continuous phototherapy in the treatment of non-haemolytic hyperbilirubinemia, with added benefits such as less frequent disruption of the mother-child relationship and reduced radiation therapy. Keywords: Intermittent phototherapy; Continuous phototherapy; Total serum bilirubin and Neonatal hyperbilirubinemia.

show abstract

Section: Discussionmentioning

confidence: 75%

Comparison of Intermittent vs. Continuous Phototherapy in the treatment of Non-Haemolytic Neonatal Hyperbilirubinemia

Ullah¹,

Khan²,

Kazemi³

et al. 2022

PJMHS

View full text Add to dashboard Cite

show abstract

“…Six RCTs were found, and of these, two were excluded: in the study by Ughasoro et al, randomization was not stratified, and children with ABO immunizations and septic newborns were included [ 23 ]; Rezaie et al included only neonates with G6PD deficiency [ 24 ]. Four RCTs were included from the initial search [ 18 , 20 – 22 ], and two additional RCTs were found from the references of included articles and included in the systematic review and meta-analysis [ 17 , 19 ] (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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 ]). Due to genetic factors related to bilirubin metabolism, these results may not be valid in other populations.…”

Section: Discussionmentioning

confidence: 99%

“…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 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2022

View full text Add to dashboard Cite

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.

show abstract

Ursodeoxycholic acid use in lactating female patients is associated with clinically negligible concentrations of this bile acid in breast milk

Šimják

Petr

Kaslová

et al. 2022

Sci Rep

View full text Add to dashboard Cite

In the literature on the safety of ursodeoxycholic acid (UDCA) during breastfeeding, insufficient data has been reported to date. Thus, the aim of our study was to analyze bile acid (BA) concentrations in breast milk in a cohort of patients, treated with UDCA, and with various cholestatic liver diseases. The study was carried out on a cohort of 20 patients with various cholestatic diseases. All the patients were treated with UDCA (500–1500 mg daily). Concentrations of BA, sampled on day 3 after delivery were analyzed using the GS-MS technique, and then compared to untreated women. Total BA concentrations in the breast milk of the UDCA-treated patients were equal to those of the untreated women controls (3.2 ± 1 vs. 3.2 ± 0.2 µmol/L, respectively). The UDCA concentrations in breast milk remained negligible in UDCA-treated patients (0.69 µmol/L), and in any event did not contribute to the newborn BA pool. No apparent side-effects of the maternal UDCA treatment were observed in any newborn infant, and no deterioration in postnatal development was observed during the routine 1-year follow-ups. Therapeutic administration of UDCA during lactation is safe for breastfed babies since UDCA only gets into breast milk in negligible amounts. UDCA treatment should be allowed and included into the guidelines for the therapy of cholestatic diseases in breastfeeding mothers.

show abstract

The effect of ursodeoxycholic acid on indirect hyperbilirubinemia in neonates treated with phototherapy: a randomized clinical trial

Cited by 10 publications

References 16 publications

Comparison of Intermittent vs. Continuous Phototherapy in the treatment of Non-Haemolytic Neonatal Hyperbilirubinemia

Comparison of Intermittent vs. Continuous Phototherapy in the treatment of Non-Haemolytic Neonatal Hyperbilirubinemia

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

Ursodeoxycholic acid use in lactating female patients is associated with clinically negligible concentrations of this bile acid in breast milk

Contact Info

Product

Resources

About