title: Clinical trial of tin mesoporphyrin to prevent neonatal hyperbilirubinemia.
abstract: To assess the efficacy of the heme oxygenase inhibitor, tin mesoporphyrin (SnMP), to reduce total bilirubin (TB) levels.
  
  
  
  Masked, SnMP (4.5 mg kg(-1)), placebo-controlled, multicenter trial of single intramuscular injection to newborns ⩾35 weeks gestational age whose predischarge screening transcutaneous bilirubin (TcB) was >75th percentile.
  
  
  
  Two hundred and thirteen newborns (median age 30 h) were randomized to treatment with SnMP (n=87) or 'sham' (n=89). We found that the duration of phototherapy was halved. Within 12 h of SnMP administration, the natural TB trajectory was reversed. At age 3 to 5 days, TB in the SnMP-treated group was +8% but sixfold lower than the 47% increase in the sham-treated group (P<0.001). At age 7 to 10 days, mean TB declined 18% (P<0.001) compared with a 7.1% increase among controls. No short-term adverse events from SnMP treatment were noted other than photoreactivity due to inadvertent exposure to white light phototherapy.
  
  
  
  Early, predischarge SnMP administration decreased the duration of phototherapy, reversed TB trajectory and reduced the severity of subsequent hyperbilirubinemia.
authors.affiliation: Division of Neonatal-Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: V K
authors.initials: VK
authors.lastname: Bhutani
authors.affiliation: Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA.
authors.forename: R
authors.initials: R
authors.lastname: Poland
authors.affiliation: Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: L D
authors.initials: LD
authors.lastname: Meloy
authors.affiliation: Department of Pediatrics, Robert Wood Johnson Hospital, New Brunswick, NJ, USA.
authors.forename: T
authors.initials: T
authors.lastname: Hegyi
authors.affiliation: Department of Pediatrics, Rainbow Babies' and Children's Hospital, Cleveland, OH, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Fanaroff
authors.affiliation: Department of Pediatrics, William Beaumont Hospital, Royal Oak, MI, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Maisels
mesh_terms: D001663:Bilirubin / Q000097:blood*; D005260:Female; D006419:Heme Oxygenase (Decyclizing) / Q000008:administration & dosage* / Q000037:antagonists & inhibitors; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008297:Male; D008665:Metalloporphyrins / Q000008:administration & dosage*; D015997:Neonatal Screening / Q000379:methods; D010789:Phototherapy / Q000379:methods; D014481:United States
chemical_list: D008665:Metalloporphyrins; C055421:tin mesoporphyrin; D006419:Heme Oxygenase (Decyclizing); D001663:Bilirubin