Effect of Prophylactic Use of Silymarin on Anti-tuberculosis Drugs Induced Hepatotoxicity
نویسندگان
چکیده
BACKGROUND The first line of anti-tuberculosis (TB) drugs are the most effective standard of drugs for TB. However, the use of these drugs is associated with hepatotoxicity. Silymarin has protective effects against hepatotoxicity of anti-TB drugs in animal models. This study aims to investigate the protective effect of silymarin on hepatotoxicity caused by anti-TB drugs. METHODS This is a prospective, randomized, double-blind and placebo-controlled study. Patients were eligible if they were 20 years of age or order and started the first-line anti-tuberculosis drugs. Eligible patients were randomized for receiving silymarin or a placebo for the first 4 weeks. The primary outcome was the proportion of patients who showed elevated serum liver enzymes more than 3 times the upper normal limit (UNL) or total bilirubin (TBil) > 2× UNL within the first 8 weeks of anti-TB treatment. RESULTS We enrolled a total of 121 patients who silymarin or a placebo to start their anti-TB treatment, for the first 8 weeks. The proportions of elevated serum liver enzymes more than 3 times of UNL at week 2, week 4, and week 8 did not show any significant difference between the silymarin and placebo groups, at 0% versus 3.6% (p>0.999); 4.4% versus 3.6% (p>0.999); and 8.7% versus 10.8% (p=0.630), respectively. However, patients with TBil >2× ULN at week 8 were significantly low in the silymarin group (0% versus 8.7%, p=0.043). CONCLUSION Our findings did not show silymarin had any significant preventive effect on the hepatotoxicity of anti-TB drugs.
منابع مشابه
Comparative study of protective effect of silymarin and n-acetyl cysteine on isoniazid induced hepatotoxicity in mice
Drug induced liver injury (DILI) leads to acute hepatitis in 10%, liver failure, and death in 30%. One of the major drugs causing DILI is Anti-tuberculous drugs and since tuberculosis is affecting 1/3rd of the total world population, their use is quite common. Use of Isoniazid (INH) is limited owing to hepatotoxicity following the stress produced by oxidative species. Silymarin has hepatoprotec...
متن کاملSilymarin protects liver against toxic effects of anti-tuberculosis drugs in experimental animals
BACKGROUND The first line anti-tuberculosis drugs isoniazid (INH), rifampicin (RIF) and pyrazinamide (PZA) continues to be the effective drugs in the treatment of tuberculosis, however, the use of these drugs is associated with toxic reactions in tissues, particularly in the liver, leading to hepatitis. Silymarin, a standard plant extract with strong antioxidant activity obtained from S. marian...
متن کاملEvaluation of Prophylactic and Therapeutic Effects of Silymarin on Phenobar- bital-Induced Hepatotoxicity in Cats
BACKGROUND: Phenobarbital is one of the most commonly used drugs to treat epilepsy and other seizure disorders in dogs and cats. Hepatotoxicity following phenobarbital administration is dose-dependent. OBJECTIVES: The present study aimed to evaluate the protective action of silymarin on phenobarbital-in- duced hepatotoxicity in cats. METHODS...
متن کاملEvaluation of Hepatoprotective Effect of Silymarin Among Under Treatment Tuberculosis Patients: A Randomized Clinical Trial
Hepatic toxicity is the most serious adverse effect of anti tuberculosis drugs. This study was performed to evaluate efficacy of silymarin as a hepatoprotective herbal agent. In a randomized double blind clinical trial 70 new cases of pulmonary tuberculosis were divided into two groups. The intervention group was assigned to receive silymarin and the control group received placebo. Tuberculosis...
متن کاملEvaluation of Hepatoprotective Effect of Silymarin Among Under Treatment Tuberculosis Patients: A Randomized Clinical Trial
Hepatic toxicity is the most serious adverse effect of anti tuberculosis drugs. This study was performed to evaluate efficacy of silymarin as a hepatoprotective herbal agent. In a randomized double blind clinical trial 70 new cases of pulmonary tuberculosis were divided into two groups. The intervention group was assigned to receive silymarin and the control group received placebo. Tuberculosis...
متن کامل