Indirect Neonatal Hyperbilirubinemia and the Role of Fenofibrate as an Adjuvant to Phototherapy

Shabo, Salam Khalid; Gargary, Khalaf Hussein; Erdeve, Ömer

doi:10.3390/children10071192

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…In a recent study, authors reported that combining conventional phototherapy with a single oral dose of 10 mg/kg fenofibrate may shorten the time it takes to lower the bilirubin levels. This supports an effect of fenofibrate as an adjuvant therapy to phototherapy in neonates that may shorten length of phototherapy and accelerate discharge from the hospital [100].…”

Section: Fibratesupporting

confidence: 59%

“Light” on Phototherapy—Complications and Strategies for Shortening Its Duration, A Review of the Literature

Shoris,

Gover,

Toropine

et al. 2023

Children

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Neonatal hyperbilirubinemia is an extremely common metabolic complication of the neonatal period which may be associated with bilirubin encephalopathy and even death. Adverse neurological consequences are preventable if a timely diagnosis and treatment are provided. Phototherapy is usually the preferred option to decrease hyperbilirubinemia. Although considered to be safe, evidence in recent years has shown that this treatment may not be free of side effects and short- and long-term unfavorable outcomes. These are usually mild or rare, but should be decreased or avoided if possible. Many useful complementary measures and treatments have been described that could shorten the duration of exposure to phototherapy. However, there is no current unequivocal recommendation to use any of the methods presented in this review. Our review aims to depict the wide range of possible complementary treatments to phototherapy, and to provide the scientific and clinical evidence available regarding their usefulness. It is essential that, while utilizing the full potential of phototherapy to treat hyperbilirubinemia, caregivers are aware of its side effects and possible inherent dangers, and seek ways to minimize the exposure to phototherapy to what is really needed for the newborn. Further studies are needed to clarify the preferred complementary treatments that could reduce the duration of exposure to phototherapy without impairing its effectiveness.

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Section: Fibratesupporting

confidence: 59%

“Light” on Phototherapy—Complications and Strategies for Shortening Its Duration, A Review of the Literature

Shoris,

Gover,

Toropine

et al. 2023

Children

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show abstract

“…New treatments for neonatal jaundice help clear bilirubin faster, reduce phototherapy time and lower the need for exchange transfusions. Practices such as infant massage, 26 and medications such as fenofibrate, 27 zinc sulphate, 28 and ursodeoxycholic acid 29 can help, although some may need a few days to show benefit. High costs and limited or no utility to prevent bilirubin-induced neurological dysfunction may constrain use in RCS.…”

Section: Adjuvant Therapymentioning

confidence: 99%

Innovative approaches to neonatal jaundice diagnosis and management in low-resourced settings

Saloojee

2024

South African Family Practice

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Persistent challenges in addressing severe neonatal hyperbilirubinaemia in resource-constrained settings have led to ongoing and often unacceptable rates of morbidity, disability and mortality. These challenges stem from limitations such as inadequate, inefficient or financially inaccessible diagnostic and therapeutic options. However, over the past decade, noteworthy innovations have emerged to address some of these hurdles, and these innovations are increasingly poised for broader implementation. This review provides a concise summary of these novel, economically viable diagnostic solutions, encompassing point-of-care assays and smartphone applications, as well as treatment modalities, notably more effective phototherapy and filtered sunlight. These advancements hold promise and have the potential to meaningfully reduce the burden of neonatal hyperbilirubinaemia, signifying a promising shift in the landscape of neonatal healthcare.

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The Impact of Administration of Fenofibrate During Suckling on Glucose Homeostasis and Programming of Metabolic Function in Adolescent Sprague Dawley Rats

Ibrahim,

Chivandi,

Erlwanger

2024

Biomed. Pharmacol. J.

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Fenofibrate, a PPAR α agonist used in the treatment of hyperlipidaemia is known to prevent diabetes and its complications. It is cautiously used during pregnancy and in neonates due to its potential for teratogenesis. The suckling period is a critical window for developmental programming. Drugs with antimetabolic syndrome activities have been used during critical developmental periods to program for protection against metabolic syndrome or its components. We evaluated the long-term metabolic effects of fenofibrate when administered during suckling and whether it would prevent the poor metabolic outcomes associated with high fructose intake in adolescent rats. A total of 119, 6-day-old (male and female) Sprague Dawley pups were randomly allocated to four groups and either orally gavaged with 10ml.kg-1 DMSO (0.5%), 100mg.kg-1 fenofibrate, 20% (w/v) fructose or both fructose and fenofibrate till 21 days after birth (PND) 21. Following weaning onto standard commercial rat cubes, the groups were split up further into two based on their drinking fluid: either fructose (20%, w/v) or tap water till PND 63 when they were subjected to an overnight fast before being terminated. Blood was taken for hormone analysis. The kidneys, pancreas, liver and visceral fat pad were weighed. Hepatic tissue was stored at -20ºC until quantification of hepatic fat content. Although the rats gained weight significantly (p<0.0001) throughout the study period, there were no significant differences in terminal body weights across the groups (p>0.05). The interventions did not significantly (p>0.05) alter concentrations of blood glucose, adiponectin and insulin. In both sexes, the HOMA-IR, liver lipids and visceral masses were similar in the different treatment groups. Fenofibrate administered to suckling rats did not adversely impact health of the study rats. It may therefore be safe for use in neonates.

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Indirect Neonatal Hyperbilirubinemia and the Role of Fenofibrate as an Adjuvant to Phototherapy

Cited by 3 publications

References 24 publications

“Light” on Phototherapy—Complications and Strategies for Shortening Its Duration, A Review of the Literature

“Light” on Phototherapy—Complications and Strategies for Shortening Its Duration, A Review of the Literature

Innovative approaches to neonatal jaundice diagnosis and management in low-resourced settings

The Impact of Administration of Fenofibrate During Suckling on Glucose Homeostasis and Programming of Metabolic Function in Adolescent Sprague Dawley Rats

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