Fenofibrate therapy may significantly lower bilirubin levels in full-term infants with newborn jaundice who have levels below the threshold for phototherapy initiation, according to a study recently published in Research Square.
Newborn jaundice is a condition in which newborns have abnormally high levels of bilirubin. Bilirubin is a byproduct of the breakdown of red blood cells and is commonly associated with hemolytic disease of the fetus and newborn (HDFN), a condition in which maternal antibodies attack the red blood cells of fetuses.
Phototherapy is an effective treatment used in treating neonatal jaundice, and most infants prescribed this form of therapy are soon discharged home if no other complications arise. However, in some newborns with jaundice, bilirubin levels fall just short of that which makes phototherapy a medical necessity.
Investigators explored if fenofibrate, a therapy that has been found to be effective in reducing bilirubin levels in infants with HDFN, can be used to treat these infants. The study included 75 full-term infants who were divided evenly into three groups: single-dose (those who received a single oral dose of 10 mg/kg of fenofibrate), double-dose (those who received two oral doses of the therapy), and the control (those who received distilled water as placebo).
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A comparison of the outcomes between these three groups showed that fenofibrate therapy is effective in treating newborns with jaundice. Infants in the double-dose group had the greatest fall in transcutaneous bilirubin levels 12 hours to 48 hours after therapy administration. Furthermore, among the three groups, infants in the double-dose group experienced the biggest fall in total serum bilirubin 12 hours to the 5th day after therapy administration.
In terms of safety, infants in the double-dose group had a higher incidence of drug adverse effects compared with those in the single-dose groups. However, only minor treatment was necessary.
“Fenofibrate, when used as a prophylactic [ie, preventative] therapy in full-term neonates with elevated bilirubin levels approaching the threshold for phototherapy, was found to be well-tolerated and effective,” the authors of the study concluded.
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