Effect of Clofibrate in Jaundiced Full-Term Infants: A Randomized Clinical Trial

Background: Hyperbilirubinemia is a common problem in newborn infants. It can progress to kernicterus in severe forms, unless an intervention is initiated. The objective of this study was to determine the therapeutic effect of clofibrate in full-term neonates with nonhemolytic jaundice. Methods: A randomized clinical trial was performed on two groups of full-term jaundiced neonates: the clofibrate-treated group (n = 30) and the control group (n = 30). Infants in the clofibrate group received a single oral dose of 100 mg/kg clofibrate while the neonates in the control group received distilled water (same color and volume); both groups received phototherapy. Serum total and direct bilirubin levels were measured at the beginning, 16, 24, 48, and 74 hours, after the start of the trial. Results: The mean ± SD total serum bilirubin level of the control and clofibrate groups at enrollment was 17.5 ± 2.3 and 18.2 ± 1.9 mg/dL, respectively (P = 0.199). The mean ± SD total serum bilirubin in the control and clofibrate groups after 48 hours was 11.4 ± 2.4 and 10.1 ± 2.4 mg/dL, respectively (P = 0.047). After 72 hours of intervention, 25 (83%) neonates of the clofibrate group and 16 (53%) of the control group were discharged with a total serum bilirubin of <10 mg/dL (P = 0.026). No side-effect was observed on serial examination during hospitalization, and on the first and seventh day after discharge. Conclusion: Clofibrate results in a faster decline in TSB, shorter duration of hospitalization and had no side effects in jaundiced full-term neonates.