Silibinin Improves the Effects of Methotrexate in Patients with Active Rheumatoid Arthritis: Pilot Clinical Study

Hussain, Saad Abdulrahman; Mortada, Ahmed; Jasim, Nazar Abdulateef; Gorial, Faiq I.

doi:10.5001/omj.2016.52

Cited by 24 publications

(11 citation statements)

References 26 publications

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“…These clinical observations are in line with the available data showing that resveratrol reduces pain, inflammation, and oedema, as well as articular destruction in experimental models of arthritis (Wang, Chen, Wang, 2016;Wang et al, 2017). Together with the previously reported data, the present finding supports the analgesic activity of dietary polyphenols in patients with mild-tomoderate knee pain, and suggests that it is in tune with the results of many pilot studies reported regarding the adjuvant use of polyphenols and other supplements during the treatment of inflammatory musculoskeletal disorders like knee OA and rheumatoid arthritis (Hussain et al, 2009;Hussain et al, 2016). Although the exact mechanism behind the impact of resveratrol on improving OA symptoms in a clinical setting has not been well described, a series of animal experiments conducted in the past few years has demonstrated that the oral administration of resveratrol is capable of significantly preventing the progression of osteoarthritis (Gu et al, 2016), and also exhibits a potent analgesic effect in different animal models (Wang et al, 2017;Bazzo et al, 2013).…”

Section: Discusionsupporting

confidence: 89%

Clinical efficacy of resveratrol as an adjuvant with meloxican in the treatment of knee osteoarthritis patients: A double-blind, randomised, placebo-controlled trial

Marouf

Hussain

Ali³

et al. 2018

Braz. J. Pharm. Sci.

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Section: Discusionsupporting

confidence: 89%

Clinical efficacy of resveratrol as an adjuvant with meloxican in the treatment of knee osteoarthritis patients: A double-blind, randomised, placebo-controlled trial

Marouf

Hussain

Ali³

et al. 2018

Braz. J. Pharm. Sci.

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“…No toxicity and adverse reaction were reported for silibinin in this trial (Hussain, Mortada, Jasim, & Gorial, 2016).…”

Section: Arthritismentioning

confidence: 69%

“…In a double‐blind clinical study, 30 males and 30 females with arthritis reheumatoid treated with methotrexate (12 mg/week) and silibinin (120 mg two times in a day) for 3 months. No toxicity and adverse reaction were reported for silibinin in this trial (Hussain, Mortada, Jasim, & Gorial, ).…”

Section: Safety and Adverse Reactions Of Oral Silymarin In Humansmentioning

confidence: 77%

Safety and toxicity of silymarin, the major constituent of milk thistle extract: An updated review

Soleimani

Delghandi

Moallem

et al. 2019

Phytotherapy Research

153

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Milk thistle (Silybum marianum) is a medicinal plant from the Asteraceae family. Silymarin is the major constituent of milk thistle extract and is a mixture of some flavonolignans such as silybin, which is the most active component of silymarin. It is most commonly known for its hepatoprotective effect. Also, studies have shown other therapeutic effects such as anticancer, anti‐Alzheimer, anti‐Parkinson, and anti‐diabetic, so its safety is very important. It has no major toxicity in animals. Silymarin was mutagen in Salmonella typhimurium strains in the presence of metabolic enzymes. Silybin, silydianin, and silychristin were not cytotoxic and genotoxic at concentration of 100 μM. Silymarin is safe in humans at therapeutic doses and is well tolerated even at a high dose of 700 mg three times a day for 24 weeks. Some gastrointestinal discomforts occurred like nausea and diarrhea. One clinical trial showed silymarin is safe in pregnancy, and there were no anomalies. Consequently, caution should be exercised during pregnancy, and more studies are needed especially in humans. Silymarin has low‐drug interactions, and it does not have major effects on cytochromes P‐450. Some studies demonstrated that the use of silymarin must be with caution when co‐administered with narrow therapeutic window drugs.

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“…Many consequences of inflammatory reactions, including oxidative stress and accelerated production of reactive oxygen species (ROS), can amplify the inflammatory response with consequent impact of increasing tissue damage and limited treatment outcomes [ 4 , 5 ]. Accordingly, the use of supplements from natural sources to attenuate the inflammation-induced oxidative damage, such as phytochemicals and trace elements, may provide further therapeutic benefits to the currently used antirheumatic agents [ 6 , 7 ]. Moreover, many of these natural supplements have the ability to potentially interfere with the inflammatory cascades, probably through attenuating the release of pro-inflammatory markers such as tumor necrosis factor-α (TNF-α) and other cytokines, which are clearly in many human and experimental animal studies [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

The adjuvant use of calcium fructoborate and borax with etanercept in patients with rheumatoid arthritis: Pilot study

Hussain

Abood

Gorial

2017

J Intercult Ethnopharmacol

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Objective:This study was designed to evaluate the effects calcium fructoborate (CFB) and sodium tetraborate (NTB) as supplements in Iraqi patients with active rheumatoid arthritis (RA) maintained on etanercept.Materials and Methods:A double-blind randomized placebo-controlled clinical trial with 60 days treatment period was carried out at Baghdad Teaching Hospital, Medical city, Baghdad, Iraq. Eighty RA patients were randomized into three groups to receive either 220 mg/day CFB, 55 mg/day NTB in capsule dosage form (equivalent to 6 mg elemental Boron), or placebo formula once daily. Only 72 patients completed the study. All patients were clinically evaluated utilizing DAS28-erythrocyte sedimentation rate (ESR), simple disease activity index-C-reactive protein (CRP), and clinical disease activity index scores at baseline, and at the end of the study. Venous blood was obtained at baseline and after 60 days, and utilized for the measurement of ESR, hemoglobin, in addition to evaluation of high-sensitivity CRP (hsCRP), tumor necrosis factor-α (TNF-α), interleukin-1α (IL-1α) and IL-6.Results:After 60 days, both types of boron significantly improve the clinical scores, in association with significant decrease in the serum levels of ESR, hsCRP, IL-1α, IL-6, and TNF-α with remarkable superiority for calcium fructoborate (CFB) over sodium tetraborate (NTB), compared to baseline and placebo-treated group.Conclusion:The use of boron, as adjuvant with etanercept, has potentiated therapeutic outcomes in RA patients, and may be a new strategy to improve treatment, and avoid the problems associated with biologics utilized in RA treatment.

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Silibinin Improves the Effects of Methotrexate in Patients with Active Rheumatoid Arthritis: Pilot Clinical Study

Abstract: Silibinin may improve the effects of MTX on certain biochemical and clinical markers of patients with active RA.

Cited by 24 publications

References 26 publications

Clinical efficacy of resveratrol as an adjuvant with meloxican in the treatment of knee osteoarthritis patients: A double-blind, randomised, placebo-controlled trial

Clinical efficacy of resveratrol as an adjuvant with meloxican in the treatment of knee osteoarthritis patients: A double-blind, randomised, placebo-controlled trial

Safety and toxicity of silymarin, the major constituent of milk thistle extract: An updated review

The adjuvant use of calcium fructoborate and borax with etanercept in patients with rheumatoid arthritis: Pilot study

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