Silymarin use and liver disease progression in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis trial
Article first published online: 2 NOV 2010
Published 2010. This article is a US Government work and is in the public domain in the USA
Alimentary Pharmacology & Therapeutics
Volume 33, Issue 1, pages 127–137, January 2011
How to Cite
Freedman, N. D., Curto, T. M., Morishima, C., Seeff, L. B., Goodman, Z. D., Wright, E. C., Sinha, R., Everhart, J. E. and the HALT-C Trial Group (2011), Silymarin use and liver disease progression in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis trial. Alimentary Pharmacology & Therapeutics, 33: 127–137. doi: 10.1111/j.1365-2036.2010.04503.x
- Issue published online: 5 DEC 2010
- Article first published online: 2 NOV 2010
- Publication data Submitted 12 July 2010 First decision 31 July 2010 Resubmitted 7 October 2010 Accepted 11 October 2010
Aliment Pharmacol Ther 2011; 33: 127–137
Background Silymarin is the most commonly used herbal product for chronic liver disease; yet, whether silymarin protects against liver disease progression remains unclear.
Aim To assess the effects of silymarin use on subsequent liver disease progression in 1049 patients of the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial who had advanced fibrosis or cirrhosis and had failed prior peginterferon plus ribavirin treatment.
Methods Patients recorded their use of silymarin at baseline and were followed up for liver disease progression (two point increase in Ishak fibrosis score across baseline, year 1.5, and year 3.5 biopsies) and over 8.65 years for clinical outcomes.
Results At baseline, 34% of patients had used silymarin, half of whom were current users. Use of silymarin was associated (P < 0.05) with male gender; oesophageal varices; higher ALT and albumin; and lower AST/ALT ratio, among other features. Baseline users had less hepatic collagen content on study biopsies and had less histological progression (HR: 0.57, 95% CI: 0.33–1.00; P-trend for longer duration of use=0.026). No effect was seen for clinical outcomes.
Conclusions Silymarin use among patients with advanced hepatitis C-related liver disease is associated with reduced progression from fibrosis to cirrhosis, but has no impact on clinical outcomes (Clinicaltrials.gov #NCT00006164).