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 .
Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon therapy: a randomized controlled trial.
CONTEXT The botanical product silymarin , an extract of milk thistle , is commonly used by patients to treat chronic liver disease , despite scant and conflicting evidence of its efficacy . OBJECTIVE To determine the effect of silymarin on liver disease activity in patients with chronic hepatitis C virus ( HCV ) infection unsuccessfully treated with interferon-based therapy . DESIGN , SETTING , AND PARTICIPANTS Multicenter , double-blind , placebo-controlled trial conducted at 4 medical centers in the United States . Participants included 154 persons with chronic HCV infection and serum alanine aminotransferase ( ALT ) levels of 65 U/L or greater who were previously unsuccessfully treated with interferon-based therapy . Enrollment began in May 2008 and was completed in May 2010 , with the last follow-up visit completed in March 2011 . INTERVENTION Participants were r and omly assigned to receive 420-mg silymarin , 700-mg silymarin , or matching placebo administered 3 times per day for 24 weeks . MAIN OUTCOME MEASURES The primary outcome measure was serum ALT level of 45 U/L or less ( considered within the normal range ) or less than 65 U/L , provided this was at least a 50 % decline from baseline values . Secondary outcomes included changes in ALT levels , HCV RNA levels , and quality -of-life measures . RESULTS After 24 weeks of treatment , only 2 participants in each treatment group ( P ≥ .99 ) met the primary outcome measure ( 3.8 % [ 95 % CI , 0.5 % to 13.2 % ] for placebo , 4.0 % [ 95 % CI , 0.5 % to 13.7 % ] for 420-mg silymarin , and 3.8 % [ 95 % CI , 0.5 % to 13.2 % ] for 700-mg silymarin ) . The mean decline in serum ALT activity at the end of treatment did not differ significantly ( P = .75 ) across the 3 treatment groups ( mean decline , -4.3 [ 95 % CI , -17.3 to 8.7 ] U/L for placebo , -14.4 [ 95 % CI , -41.6 to 12.7 ] U/L for 420-mg silymarin , -11.3 [ 95 % CI , -27.9 to 5.4 ] U/L for 700-mg silymarin ) ; there likewise were no significant differences in HCV RNA levels ( mean change , 0.07 [ 95 % CI , -0.05 to 0.18 ] log10 IU/mL for placebo , -0.03 [ 95 % CI , -0.18 to 0.12 ] log10 IU/mL for 420-mg silymarin , 0.04 [ 95 % CI , -0.08 to 0.16 ] log10 IU/mL for 700-mg silymarin ; P = .54 ) or quality -of-life measures . The adverse event profile of silymarin was comparable with that of placebo . CONCLUSION Higher than customary doses of silymarin did not significantly reduce serum ALT levels more than placebo in participants with chronic HCV infection unsuccessfully treated with interferon-based therapy . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00680342
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 .