Role of ursodeoxycholic acid in neonates with indirect hyperbilirubinemia-an open labelled randomised control trial

Shazia Jafari; Kabeer A. Khan; Shrish Bhatnagar; Geetika Srivastava; Chhavi Nanda; Anu Chandra

doi:10.18203/2349-3291.ijcp20180530

Authors

Shazia Jafari Department of Pediatrics, ERA's Lucknow Medical College, Lucknow, Uttar Pradesh, India
Kabeer A. Khan Department of Pediatrics, ERA's Lucknow Medical College, Lucknow, Uttar Pradesh, India
Shrish Bhatnagar Department of Pediatrics, ERA's Lucknow Medical College, Lucknow, Uttar Pradesh, India
Geetika Srivastava Department of Pediatrics, ERA's Lucknow Medical College, Lucknow, Uttar Pradesh, India
Chhavi Nanda Department of Pediatrics, ERA's Lucknow Medical College, Lucknow, Uttar Pradesh, India
Anu Chandra Department of Pediatrics, ERA's Lucknow Medical College, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20180530

Keywords:

Indirect hyperbilirubinemia, Phototherapy, UDCA

Abstract

Background: Ursodeoxycholic Acid (UDCA) is a bile acid widely used in the treatment of cholestatic liver disorders. Few studies have been conducted using UDCA in indirect hyperbilirubinemia. We planned this study to know the role of Ursodeoxycholic acid on indirect hyperbilirubinemia in neonates

Methods: The study was conducted in Department of Paediatrics and Neonatology at Eras Lucknow Medical College and Hospital from November 2015 to September 2017 in 96 term neonates with total bilirubin levels in phototherapy range. They were randomized into 3 Groups receiving either phototherapy only or UDCA at 10mg/kg/day or 20mg/kg/day along with phototherapy.

Results: Present study showed that there was a higher rate of fall and less duration of phototherapy required in children receiving UDCA. However, there was no difference in the group receiving 10mg vs 20 mg /kg/day

Conclusions: We conclude that by giving UDCA at 10mg/kg/day along with phototherapy in neonate with indirect hyperbilirubinemia leads to faster resolution of hyperbilirubinemia.

Metrics

Metrics Loading ...

References

Tikmani SS, Warraich HJ, Abbasi F, Rizvi A, Darmstadt GL, Zaidi AK. Incidence of neonatal hyperbilirubinemia: a population-based prospective study in Pakistan. Trop Med Int Health. 2010;15(5):502-7.

Onyearugha C, Onyire BN, Ugboma AA. Neonatal jaundice: prevalence and associated factors as seen in Federal Medical Centre Abakaliki, Southeast Nigeria. J Clin Med Res. 2011;3(3):40-5.

Kaini NR, Chaudhary D, Adhikary V, Bhattacharya S, Lamsal M. Overview of cases and prevalence of jaundice in neonatal intensive care unit. Nepal Med Coll J. 2006;8(2):133-5.

Honar N, Saadi GE, Saki F, Pishva N, Shakibazad N, Teshnizi HS. Effect of ursodeoxycholic acid on indirect hyperbilirubinemia in neonates treated with phototherapy. J Pediatr Gastroenterol Nutr. 2016;62(1):97-100

Pashapour N, Maccoei A, Sariyeh G, Hossein A. The study of a new method in treatment of term newborns with non-hemolytic hyperbilirubinemia. Med J Islamic World Academy Sci. 2010;18(1):5-8.

Mendez-Sanchez N, Brink MA, Paigen B. Ursodeoxycholic acid and cholesterol induce enterohepatic cycling of bilirubin in rodents. Gastroenterol. 1998;115:722-32.

Balistreri WF. Bile acid therapy in pediatric hepatobiliary disease: the role of ursodeoxycholic acid. J Pediatr Gastroenterol Nutr. 1997;24:573-89.

Stang A. Randomized controlled trials—an indispensible part of clinical research. Deutsches Ärzteblatt Int. 2011;108(39):661-2.

Cuperus FJ, Hafkamp AM, Havinga R. Effective treatment of uconjugated hyperbilirubinemia with oral bile salts in Gunn rats. Gastroenterol. 2009;136:673-82.

Dinler G, Koçak N, Yüce A, Gürakan F, Ozen H. Ursodeoxycholic acid therapy in children with cholestatic liver disease. Turk J Pediatr. 1999;41(1):91-8.

Al-Hathlol K, Al-Madani A, Al-Saif S, Abulaimoun B, AlTawil K, El-Demerdash A. Ursodeoxycholic acid therapy for intractable total parenteral nutrition-associated cholestasis in surgical very low birth weight infants. Singapore Med J. 2006;47:147-51.

Hassan AM, Abdulrahman A, Husain RH. Effect of Ursodeoxycholic acid in lowering neonatal indirect hyperbilirubinemia: a randomized controlled trial. Merit Res J Med Med Sci. 2015;3(9):402-5.