|
Clinical Question:
What is the role of Silymarin in patient with Chronic Viral Hepatitis?
Bottom Line:
Silymarin compounds likely decrease serum transaminases in patients with
chronic viral hepatitis, but do not appear to affect viral load or liver
histology. Nevertheless it may be worthwhile to determine its effects in
conjunction with standard antiviral treatment.
Reference:
Silymarin treatment of viral hepatitis, Mayer KE, Myers RP, Lee SS.J Viral
Hepat. 2005 Nov;12(6):559-67.
Study Design:
Sytematic Review
Synopsis:
Silymarin from the milk thistle herb (Silybum marianum) is used by many
patients with chronic viral hepatitis, but its efficacy remains unknown. We
performed a systematic review of silymarin for the treatment of chronic
viral hepatitis B and C. An exhaustive search strategy identified 148 papers
that studied silymarin compounds in liver disease. Of these, four trials
included patients with hepatitis C, one included hepatitis B patients, and
two, unspecified chronic viral hepatitis. However, only one trial
exclusively studied patients with hepatitis C, and none involved patients
with only hepatitis B. Silymarin treatment resulted in a decrease in serum
transaminases compared with baseline in four studies, and compared with
placebo in only one study. There is no evidence that silymarin affects viral
load or improves liver histology in hepatitis B or C. No studies were found
that investigated the use of silymarin concomitantly with interferon,
nucleoside analogues, or other conventional treatments for hepatitis B or C. |