<p>Reductive effect of ursodeoxycholic acid on bilirubin levels in neonates on phototherapy</p>

Abstract

Background Phototherapy is paramount in the management of high total serum bilirubin (TSB). Whether its effectiveness can be improved with ursodeoxycholic acid (UDCA) has not been evaluated among newborns of African descent. Methods A double-blind-controlled study was used to evaluate the effect of UDCA on the management of high TSB in neonates. Recruited neonates were categorized into the experimental group (given UDCA plus phototherapy) and the control group (phototherapy and plain syrup), and their TSB and conjugated bilirubin levels were measured. The data were analyzed using SPSS version 20. Statistical significance was set at a p -value of <0.05. Results The mean (SD) percentage reductions in TSB after 24 hrs were 40.73% (18.1) and 10.21% (7.1) in the experimental and control groups, respectively, and the difference was statistically significant ( p =0.001). The mean (SD) durations on therapy were 3.0 days (0.58) in the experimental group and 5.5 days (1.35) in the control group ( p =0.001). Conclusions Phototherapy is still effective in the management of neonatal hyperbilirubinemia, but inclusion of UDCA accentuates the reductive effect of phototherapy on the TSB in neonates, reducing the duration of treatment and in-patient care.

Intervention to Reduce Bilirubin Levels in Newborn Babies: A Systematic Review

“…Wikanthiningtyas and Mulyanti (2016) explained that bed rest during phototherapy had a significant effect on bilirubin levels in neonatal jaundice in the Neonatus High Care Unit of RSUD Dr. Moewardi with a P-val of 0.00. The results of both studies have similarities with research conducted by Ughasoro, et al (2019) explaining that phototherapy is still effective in the management of neonatal hyperbilirubinemia, but the inclusion of UDCA (urso deoxycholic acid) accentuates the reductive effect of phototherapy on total serum bilirubin in neonates, reduce the duration of treatment and inpatient care…”

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

“…Finally, as we reported in our previous experimental studies on hyperbilirubinemic Gunn rats, UDCA in clinically relevant doses substantially increased turnover of unconjugated bilirubin, with a drop of bilirubin concentrations in the vascular bed comparable to that of phototherapy 32,33 ; establishing a rationale for the use of UDCA in the treatment of severe neonatal jaundice. Indeed, this hypobilirubinemic effect of UDCA has recently been proven in several clinical studies on human neonates suffering from serious unconjugated hyperbilirubinemia, with no apparent adverse reactions attributable to administration of UDCA [34][35][36][37][38] .…”

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

“…The initial search yielded 376 studies, of which 17 were further assessed in the full text phase. 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.…”

“…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 ].…”