Clofibrate for Unconjugated Hyperbilirubinemia in Neonates: A Systematic Review.

ABSTRACT

Objective: To evaluate the effect of clofibrate for unconjugated hyperbilirubinemia in neonates. Methods: A systematic review with meta-analysis of randomized controlled trials or quasi-randomized controlled trials was conducted to evaluate the clofibrate treatment in neonates with unconjugated hyperbilirubinemia. We followed the guidelines from the Cochrane review group and the PRISMA statement. Results: Of 148 studies identified, a total of 13 studies on 867 infants were included. A single oral administration of clofibrate was associated with decreased need of phototherapy (RR.38, 95% CI 0.21 to 0.68), shortened duration of phototherapy (mean duration 23.88 h, 95% CI 33.03 to -14.72 h) and reduced peak total serum bilirubin (mean duration -1.62 mg/dL, 95% CI 2.13 to -1.11 mg/dL). These effects were especially obvious in term infants and infants without hemolytic diseases. Data regarding mortality or kernicterus were not available from included studies. Conclusions: Clofibrate may have short-term benefits for the infants with hyperbilirubinaemia, especially for population of term infants and infants without hemolytic diseases. Large RCTs with long-term followup are required to verify the safety of clofibrate and assess its long-term effects.