An Updated Systematic Review with Meta-Analysis for the Clinical Evidence of Silymarin

@article{Saller2008AnUS,
  title={An Updated Systematic Review with Meta-Analysis for the Clinical Evidence of Silymarin},
  author={R. Saller and Reto Brignoli and J{\"o}rg Melzer and R{\'e}my F. Meier},
  journal={Complementary Medicine Research},
  year={2008},
  volume={15},
  pages={9 - 20}
}
Background: The potential benefit of silymarin (special extract from the fruits of Silybum marianum) in the treatment of liver diseases remains a controversial issue. Methods: For this systematic review electronic databases identified 65 papers for the search terms silymarin, silibinin, silicristin or milk thistle and clinical trial. Only 19 complied with the criteria ‘double-’ or ‘single-blind’. These publications were analysed from a clinical point of view and meta-analytic calculations were… 
Effect of silymarin on biochemical indicators in patients with liver disease: Systematic review with meta-analysis
TLDR
Silymarin minimally reduced, but without clinical relevance, the serum levels of ALT and AST, and a meta-analysis of ramdomized and controlled clinical trials revealed no significant change in the γGT levels.
The effects of silymarin on type 2 diabetes mellitus: A systematic review and meta-analysis
TLDR
It is suggested that silymarin administration has beneficial effects on glycemic indices such as FBS, HbA1c but the results for lipid profile ingredients (TC, TG) are imprecise uncertain, and overall the available evidence is insufficient to make a firm conclusion.
Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review
TLDR
Treatment with silymarin should be initiated as early as possible in patients with fatty liver disease and other distinct liver disease manifestations such as acute liver failure, when the regenerative potential of the liver is still high and when removal of oxidative stress, the cause of cytotoxicity, can achieve the best results.
The potential of silymarin for the treatment of hepatic disorders
TLDR
Despite promising new experimental and clinical data, further clinical studies are required including long-term observations and the application of hard clinical endpoints, to further support silymarin’s use for the treatment of hepatic diseases.
Dietary supplementation in patients with alcoholic liver disease: a review on current evidence.
TLDR
Since oxidative stress and inflammation are involved in the pathogenesis of ALD, dietary supplements that can modulate these pathologies could be useful in the treatment ofALD.
The effects of silymarin supplementation on metabolic status and oxidative stress in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of clinical trials.
TLDR
The data suggest that silymarin supplements have beneficial effects on metabolic status and oxidative stress among patients with T2DM, however, there is currently insufficient evidence to make firm conclusions about the full efficacy of supplementation.
[Silymarin in the treatment of chronic liver diseases: past and future].
TLDR
The results support the administration of silymarin preparations in the therapy of chronic liver diseases, especially in alcoholic and non-alcoholic steatohepatitis in current clinical practice, and as it can be awaited, also in the future.
Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon therapy: a randomized controlled trial.
TLDR
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.
Comparison of efficacy of folic acid and silymarin in the management of antiepileptic drug induced liver injury: a randomized clinical trial.
TLDR
Although both treatments were safe and effective in decreasing liver enzymes, folic acid seems to be superior to silymarin in the management of DILI.
Siliphos Selenium Methionine Alpha Lipoic Acid for Non Alcoholic Fatty Liver Disease: Results of a Pilot Study
TLDR
Treatment for 6 months may protect against worsening steatosis and improve the inflammatory profile and the reduced antioxidant status noted in NAFLD patients showed improvement with this therapy.
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References

SHOWING 1-10 OF 115 REFERENCES
[Silymarin for the treatment of acute viral hepatitis? Report of a controlled trial (author's transl)].
TLDR
It is concluded that Silymarin has no favourable effects on the cause of acute viral hepatitis.
Silymarin treatment of viral hepatitis: a systematic review
TLDR
Silymarin compounds likely decrease serum transaminases in patients with chronic viral hepatitis, but do not appear to affect viral load or liver histology, and it may be worthwhile to determine its effects in conjunction with standard antiviral treatment.
Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial.
TLDR
The results of this study indicate that silymarin has no effect on survival and the clinical course in alcoholics with liver cirrhosis.
[Treatment of alcoholic hepatitis with silymarin. A double-blind comparative study in 116 patients].
TLDR
Silymarin 420 mg/d is not clinically relevant in the treatment of moderate alcoholic hepatitis, and significant improvement in the score of alcoholic hepatitis and serum amino transferase activity, was noted in both groups during the trial, irrespective of treatment with sily marin or placebo.
Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver.
TLDR
Analysis of subgroups indicated that treatment was effective in patients with alcoholic cirrhosis and in patients initially rated 'Child A' (P = 0.01) and in customers initially rated "Child A" (P= 0.03).
[Controlled study of the effect of silymarin on alcoholic liver disease].
TLDR
It is concluded that in this trial, Silymarin did not change the evolution or mortality of alcoholic liver disease, and final laboratory values and their changes in those who survived did not differ between Sily marin and placebo.
An Updated Systematic Review of the Pharmacology of Silymarin
TLDR
Silymarin may be a natural multi-functional and multi-target drug that has skin protective properties against UV-induced damage in epidermis and causes an up-regulation of tumour-suppressor genes p53- and p21CIP1.
Effects of silymarin MZ-80 on oxidative stress in patients with alcoholic cirrhosis. Results of a randomized, double-blind, placebo-controlled clinical study.
TLDR
Silymarin is well-tolerated and produces a small increase in glutathione and a decrease in lipid peroxidation in peripheral blood cells in patients with alcoholic liver cirrhosis, and no changes in routine liver tests were observed during the course of therapy.
Use of herbal supplements for chronic liver disease.
  • C. Levy, Leonard Seeff, K. Lindor
  • Medicine
    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2004
TLDR
Based on current evidence, the use of herbal supplements for the routine treatment of any chronic liver disease and further well-designed clinical trials are necessary.
Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid
TLDR
Although silymarin was well tolerated, this medication did not provide benefit to patients with PBC responding suboptimally to UDCA, and the results of this pilot study would seem to discourage further controlled trials of sily marin in patients withPBC.
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