There was no significant change in the γGT levels .
Significant differences were not found .
CONCLUSION Silymarin minimally reduced , but without clinical relevance , the serum levels of ALT and AST .
AIM To evaluate the effect of silymarin on the serum levels of alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) and gamma glutamyl transpeptidase ( γGT ) in patients with liver diseases .
A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury
Background Hepatitis is a common adverse effect of antituberculosis drugs . Silymarin prevented drug-induced hepatoxicity in animals with anti-oxidative mechanisms but its effect in human has been unknown . We aim ed to evaluate the efficacy of silymarin for preventing antituberculosis-drug induced liver injury ( antiTB-DILI ) in patients with tuberculosis . Methods A double-blind r and omized placebo-controlled trial was performed . Tuberculosis patients were r and omly allocated to receive placebo or silymarin . The outcomes of interests were antiTB-DILI and the maximum liver enzymes at week 4 . Antioxidative enzymes ( i.e. , superoxide dismutase ( SOD ) , glutathione and malondialdehyde assays ) were assessed . The risks of antiTB-DILI between the two groups were compared . A number need to treat was estimated . Results A total of 55 out of 70 expected numbers of patients were enrolled . There were 1/27 ( 3.7 % ) and 9/28 ( 32.1 % ) patients who developed antiTB-DILI in the silymarin and the placebo groups . Risk reduction was 0.28 ( 0.10 , 0.47 ) , i.e. , receiving silymarin was 28 % at lower risk for antiTB-DILI than placebo . This led to prevention of 28 patients from being antiTB-DILI among 100 treated patients . Median ( IQR ) of ALT levels at week 4 in the placebo and the silymarin group were 35.0 ( 15 , 415 ) IU/L and 31.5 ( 20 , 184 ) IU/L ( p = 0.455 ) . The decline of SOD level at week 4 in the silymarin group was less than the placebo group ( p < 0.027 ) . Conclusions Silymarin reduced the incidence of antiTB-DILI . The benefit of silymarin may be explained from superoxide dismutase restoration . Larger clinical trials are required to confirm the result of our small study [ Clinical trials . Gov Identifier Nct01800487 ]
There was no significant change in the γGT levels .
Significant differences were not found .
CONCLUSION Silymarin minimally reduced , but without clinical relevance , the serum levels of ALT and AST .
AIM To evaluate the effect of silymarin on the serum levels of alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) and gamma glutamyl transpeptidase ( γGT ) in patients with liver diseases .