Journal Article

High Dose of Silymarin in Patients with Decompensated Liver Disease: A Randomized Controlled Trial

Fathalah, Waleed Fouad, Abou el Soud, Neveen Helmy, Abdel Aziz, Mohamed AbdAllah, El Raziky, Maissa El Said

2017

Overview

Hepatitis C virus (HCV) is a major public health problem being the most common cause of chronic liver disease in Egypt. HCV-induced decompensated liver cirrhosis patients have a median survival of 2 years even with currently used new treatments. Silymarin is the most commonly used herbal product in chronic liver disease for its anti-inflammatory, antiviral, antioxidant, and antifibrotic effects. The aim of this study was to assess the effects of silymarin in high dose on the clinical and biochemical status of chronic HCV-associated decompensated liver cirrhosis. The study was conducted on 62 chronic HCV-decompensated cirrhotic patients. Patients were randomized according to treatment plans: group A, included 31 patients who received silymarin in dose of 1,050 mg/day, and group B, included 31 patients who received silymarin in dose of 420 mg/day. Patients were subjected to baseline history taking, laboratory evaluation, abdominal ultrasound, Child scoring, and quality-of-life (QoL) questionnaire. Follow-up was done every 2 weeks for 12 weeks. Silymarin in high dose had an effect on reducing alanine transaminase, aspartate aminotransferase levels (P ≤ 0.01), as well as improving albumin (P = 0.04), bilirubin (P = 0.02), and international normalized ratio (P = 0.03), thus resulted in improvement in Child score (P = 0.048), however, regular silymarin regimen (420 mg/day) failed to achieve the previous biochemical changes. High-dose regimen of silymarin also had a positive impact on improving QoL. No serious adverse events were reported. Silymarin in high dose is a good choice for improvement of liver biochemical profile and QoL in chronic HCV cirrhotic patients.

• Publisher: SAGE Publications,Mary Ann Liebert, Inc
• Subject: Alanine / Alanine transaminase / Albumins - metabolism / Antioxidants / Aspartate aminotransferase / Bilirubin / Bilirubin - metabolism / Biochemistry / Children & youth / Cirrhosis / Disease control / Dose-Response Relationship, Drug / Drug dosages / Female / Follow-Up Studies / Gastroenterology / Hemoglobins - metabolism / Hepatitis / Hepatitis C / Hepatology / Humans / Infections / Interferon / Laboratories / Leukocyte Count / Liver / Liver cirrhosis / Liver diseases / Liver Diseases - drug therapy / Male / Medical research / Medicine / Middle Aged / Patients / Public health / Questionnaires / Silymarin / Silymarin - administration & dosage / Silymarin - adverse effects / Silymarin - pharmacology / Silymarin - therapeutic use / Studies / Surveys and Questionnaires / Transaminase / Ultrasound / Viral infections / Viruses