A Randomized Trial of Silymarin for the Treatment of Nonalcoholic Steatohepatitis

Chan, Wah‐Kheong; Mustapha, Nik Raihan Nik; Mahadeva, Sanjiv

doi:10.1016/j.cgh.2017.04.016

Cited by 180 publications

(170 citation statements)

References 38 publications

Supporting

Mentioning

150

Contrasting

Unclassified

Order By: Relevance

“…In contrast to the previously mentioned study, a randomized, double blind, placebo‐controlled trial used higher doses of silymarin (700 mg, trice daily for 48 weeks) in patients diagnosed with NASH and a NAFLD activity score (NAS) of ≥4. Despite improvement in fibrosis, no significant reduction was observed either in NAS or in the liver function tests compared to that of the placebo …”

Section: Human Studiesmentioning

confidence: 82%

Effects of silymarin on metabolic syndrome: a review

2018

View full text Add to dashboard Cite

Metabolic syndrome is one of the rising global health problems and medical challenges due to several clinical complications it may cause, for example increasing the risk of myocardial infarction and hypertension. However, great attention has been directed toward determining the worthiness of herbal medicines. There are emerging studies on preventive and therapeutic effects of silymarin on different components of metabolic syndrome. Extracted from the dried seeds of milk thistle plant (Silybum marianum L.), silymarin has been used in the treatment of different diseases for many years. Several protective effects have been identified for this herb such as decreasing insulin resistance, regulating blood pressure and lipid profile, as well as antioxidant and cytoprotective effects. This review aims to discuss available human and experimental researches into the promising effects of silymarin on different elements of metabolic syndrome. All related human and experimental papers published from 2012 to date were included in this review. Reviewing different human and experimental studies into the effects of silymarin on metabolic syndrome, we deduced that silymarin possesses promising effects on different components of this syndrome. Although the complete mechanism of action and target organs for silymarin require further verification and investigation, high-risk individuals may benefit from supplementation with this herbal medicine. © 2018 Society of Chemical Industry.

show abstract

Section: Human Studiesmentioning

confidence: 82%

Effects of silymarin on metabolic syndrome: a review

2018

View full text Add to dashboard Cite

show abstract

“…Two studies36 133 considered decrease in ALT without specifying as the response. One study each has defined the response rate as the end of treatment fibrosis stage less than baseline,39 decrease in 30% NAS,134 decrease in ALT by at least 0.3 times the upper limit of normal reference range,77 decrease in steatosis >30% compared with baseline,48 at least 50% decrease in aminotransferases83 and one did not have any specific definition of responders 69. For studies (877 patients) with the criterion of NAS improvement by at least two points, elafibranor (OR 2.37; 95% CI 1.2 to 4.7), obeticholic acid (OR 3.12; 95% CI 1.7 to 5.6), pentoxifylline (OR 4.3; 95% CI 1.4 to 13.6), telmisartan (OR 7.4; 95% CI 1.2 to 45) and vitamin E (OR 3.5; 95% CI 1.5 to 6.9) were observed to perform better than standard of care (online supplementary figure S4).…”

Section: Resultsmentioning

confidence: 99%

Pharmacological interventions for non-alcoholic fatty liver disease: a systematic review and network meta-analysis

Sridharan

Sivaramakrishnan

Sequeira

et al. 2018

Postgraduate Medical Journal

View full text Add to dashboard Cite

AimSeveral drugs have been used for treating non-alcoholic fatty liver disease (NAFLD). The present study is a network meta-analysis of such drugs.Design, setting and patientsRandomised clinical trials comparing drug interventions in patients with NAFLD were analysed. OR and weighted mean difference (95 % CI) were the effect estimates for categorical and numerical outcomes, respectively. Random-effects model was used to generate pooled estimates. Surface under the cumulative ranking curve was used to rank the treatments.Main outcome measuresProportion of responders was the primary outcome measure and non-alcoholic steatohepatitis scores, liver enzymes, lipid profile, body mass index, homeostatic model assessment of insulin resistance, intrahepatic fat and adverse events were the key secondary outcomes.Results116 studies were included in the systematic review and 106 in the meta-analysis. Elafibranor, gemfibrozil, metadoxine, obeticholic acid, pentoxifylline, pioglitazone, probiotics, telmisartan, vildagliptin and vitamin E significantly increased the response rate than standard of care. Various other drugs were observed to modify the secondary outcomes favourably. Probiotics was found with a better response in children; and elafibranor, obeticholic acid, pentoxifylline and pioglitazone in patients with type 2 diabetes mellitus. The quality of evidence observed was either low or very low.ConclusionIn patients with NAFLD, several drugs have been shown to have variable therapeutic benefit. However, the estimates and the inferences should be considered with extreme caution as it might change with the advent of future head-to-head clinical trials.

show abstract

“…The PO bioavailability of silymarin is low (30%‐50%) and the half‐life short (4‐6 hours), meaning high doses and repeated administration are necessary to obtain therapeutic concentrations . Studies of silymarin in humans, including National Institutes of Health‐sponsored clinical trials using highly standardized preparations, have failed to achieve projected therapeutic endpoints …”

Section: Treatmentmentioning

confidence: 99%

ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

Webster

Cullen

Penninck

et al. 2019

Veterinary Internal Medicne

198

View full text Add to dashboard Cite

This consensus statement on chronic hepatitis (CH) in dogs is based on the expert opinion of 7 specialists with extensive experience in diagnosing, treating, and conducting clinical research in hepatology in dogs. It was generated from expert opinion and information gathered from searching of PubMed for manuscripts on CH, the Veterinary Information Network for abstracts and conference proceeding from annual meetings of the American College of Veterinary Medicine and the European College of Veterinary Medicine, and selected manuscripts from the human literature on CH. The panel recognizes that the diagnosis and treatment of CH in the dog is a complex process that requires integration of clinical presentation with clinical pathology, diagnostic imaging, and hepatic biopsy. Essential to this process is an index of suspicion for CH, knowledge of how to best collect tissue samples, access to a pathologist with experience in assessing hepatic histopathology, knowledge of reasonable medical interventions, and a strategy for monitoring treatment response and complications.

show abstract

A Randomized Trial of Silymarin for the Treatment of Nonalcoholic Steatohepatitis

Cited by 180 publications

References 38 publications

Effects of silymarin on metabolic syndrome: a review

Effects of silymarin on metabolic syndrome: a review

Pharmacological interventions for non-alcoholic fatty liver disease: a systematic review and network meta-analysis

ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

Contact Info

Product

Resources

About