1. Efficacy and safety of fenofibrate in combination with phototherapy for the treatment of neonatal hyperbilirubinemia: a systematic review and meta-analyses.
- Author
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Abdellatif M, Abozaid AAF, Shah PS, Dhouibi N, Nguyen-Khac T, Khleif R, Luu MN, Quyen DK, Mohareb A, Vaghela G, Khan ZA, Pham HN, Makram AM, and Huy NT
- Subjects
- Humans, Infant, Newborn, Bilirubin blood, Combined Modality Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Fenofibrate adverse effects, Fenofibrate therapeutic use, Hyperbilirubinemia, Neonatal therapy, Phototherapy methods, Phototherapy adverse effects
- Abstract
Phototherapy is the standard treatment for neonatal jaundice. We aimed to review the efficacy and safety of fenofibrate as an adjunct therapy. Twelve databases were searched and a systematic review and meta-analysis were conducted. Mean change (MC), mean difference (MD), and risk ratios (RR) with a 95% confidence interval (CI) were calculated using a random effects model. The GRADE approach was used to evaluate the evidence's certainty. Nine randomized trials were included. The MC of total serum bilirubin (mg/dL) was significant at 12, 24, 36, 48, and 72 h with respective MC (95% CI) values of -0.46 (-0.61, -0.310), -1.10 (-1.68, -0.52), -2.06 (-2.20, -1.91), -2.15 (-2.74, -1.56), and -1.13 (-1.71, -0.55). The FEN + PT group had a shorter duration of phototherapy (MD: -14.36 h; 95% CI: -23.67, -5.06) and a shorter hospital stay (MD: -1.40 days; 95% CI: -2.14, -0.66). There was no significant difference in the risk of complications (RR: 0.89; 95% CI: 0.54, 1.46) or the need for exchange transfusion (RR: 0.58; 95% CI: 0.12, 2.81). The certainty of the evidence was very low for all outcomes. In conclusion, fenofibrate might be a safe adjunct to neonatal phototherapy. Larger randomized controlled trials are needed for the confirmation of these results., Competing Interests: The authors declare that they have no conflict of interest.
- Published
- 2024
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