Exploring The Role of Peroxisome Proliferator- Activated Receptor Agonists (Fenofibrate) in Neonatal Jaundice Prevention

Background: Neonatal jaundice is one of the most prevalent illnesses in neonates, requiring care and treatment. Fenofibrate is a lipid-lowering drug that enhances the conjugation and excretion of bilirubin. Previous studies have suggested the usefulness of fenofibrate for the treatment of indirect hyperbilirubinemia in neonates. Objective: To evaluate the role of fenofibrate in neonates with neonatal jaundice near the level of phototherapy. Patients and Methods: seventy- five full-term infants with neonatal jaundice near the level of phototherapy were randomly divided into three groups: single-dose group: 25 neonates received a single oral dose of 10 mg/kg of non-micronized fenofibrate and an oral dose of an equivalent amount of distilled water as a placebo . Double-dose group: 25 neonates received two oral doses of 10 mg/kg non-micronized fenofibrate. The control group included 25 neonates who received two oral doses of an equivalent amount of distilled water as a placebo. Results: The double-dose group had the highest significant drop in transcutaneous bilirubin (TCB) starting from 12 to 48 h after drug intake and the highest drop in total serum bilirubin (TSB) starting from 12 h to the 5 ^th day in comparison to the single-dose group and the controls. The single-dose and double-dose groups had a significantly lower incidence of the need for admission and phototherapy than the control group (P=0.009). The double-dose group had a significantly higher incidence of drug side effects than the single-dose group (P< 0.001), mainly in the form of abdominal distension (P=0.008); however, only minor treatment was required. Conclusion: Fenofibrate can significantly decrease bilirubin levels in full-term neonates with neonatal jaundice near the level of phototherapy, with no need for admission and phototherapy management. The drug was well-tolerated and safe. Double-dose treatment with fenofibrate significantly lowered TSB with no significant increase in side effects when compared to the single-dose group.