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Efficacy of clofibrate on severe neonatal jaundice associated with glucose-6-phosphate dehydrogenase deficiency (a

Yadollah Zahedpasha1, Mousa Ahmadpour-Kacho, Mahmood Hajiahmadi

  • 1Pediatric Research Center, Amirkola Children Hospital, Department of Pediatric, School of Medicine, Babol University of Medical Sciences, Babol, Iran. yzpasha@yahoo.com

The Southeast Asian Journal of Tropical Medicine and Public Health
|June 21, 2008
PubMed

Insights

Clofibrate treatment significantly reduced total serum bilirubin levels in full-term neonates with Glucose-6-phosphate dehydrogenase (G6PD) deficiency. This intervention led to shorter phototherapy and hospitalization durations without observed side effects.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pharmacology
  • Clinical Biochemistry

Background:

  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common genetic disorder that can lead to severe hyperbilirubinemia in newborns.
  • Unmanaged hyperbilirubinemia in G6PD deficient neonates poses a risk of bilirubin encephalopathy, necessitating effective interventions.
  • Phototherapy is a standard treatment, but adjunct therapies may improve outcomes and reduce treatment duration.

Purpose of the Study:

  • To evaluate the efficacy of clofibrate as an adjunct therapy for jaundice in full-term neonates diagnosed with G6PD deficiency.
  • To assess the impact of clofibrate on serum bilirubin levels, phototherapy duration, and hospitalization length.

Main Methods:

  • A randomized clinical trial involving full-term G6PD deficient neonates with jaundice.
  • Two groups were studied: one received a single oral dose of 100 mg/kg clofibrate plus phototherapy, while the control group received only phototherapy.
  • Serum total and direct bilirubin levels were monitored at baseline and at 16, 24, and 48 hours post-treatment initiation.

Main Results:

  • The clofibrate group showed a significantly faster decline in mean total serum bilirubin (TSB) levels compared to the control group at 16, 24, and 48 hours (p=0.047 at 48 hours).
  • At 48 hours, a higher proportion of infants in the clofibrate group (33%) were discharged with TSB < 10 mg/dl compared to the control group (5%) (p=0.031).
  • No adverse side effects of clofibrate were observed during hospitalization or follow-up assessments.

Conclusions:

  • Clofibrate is an effective and safe adjunct treatment for reducing hyperbilirubinemia in full-term neonates with G6PD deficiency.
  • The use of clofibrate can lead to a shorter duration of phototherapy and hospitalization.
  • Further research may explore optimal dosing and long-term effects, but initial findings support its clinical utility.

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