http://www.indianpediatrics.net/jan2012/35.pdf

Clofibrate for Unconjugated Hyperbilirubinemia in Neonates.

A Systematic Review
TAO XIONG, DAPENG CHEN, ZHOUJIN DUAN, YI QU AND DEZHI MU*
From the Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China and *Department of Neurology and Pediatrics, Newborn Brain Research Institute, University of California, San Francisco, California, USA.
Correspondence to: Dezhi Mu, Department of Pediatrics, West China Second University Hospital, Sichuan University, China.
dezhi.mu@ucsf.edu

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.
Key words: Clofibrate, Jaundice, Management, Meta-analysis, Newborn, Phototherapy.