title: Silymarin in the treatment of patients with primary sclerosing cholangitis: an open-label pilot study.
abstract: No effective medical therapy is available for patients with primary sclerosing cholangitis (PSC). We evaluated the safety and estimated the efficacy of silymarin in patients with PSC in a pilot study. Thirty patients with PSC were enrolled. Silymarin, 140 mg orally three times daily, was given for 1 year. A statistically significant improvement in serum alkaline phosphatase activity (1131 +/- 216 vs. 861 +/- 139, P = 0.007), and aspartate aminotransferase (AST) levels (116 +/- 15 vs. 83 +/- 11, P = 0.01) occurred with treatment. Serum bilirubin levels were not significantly affected by the treatment, while serum albumin and the Mayo risk score remained essentially unchanged. Overall, 34% of patients had a positive response to silymarin as defined by > or =50% improvement or normal status in liver tests. The results of this pilot study warrant further evaluation of silymarin in patients with PSC in a large-scale, controlled trial.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA. angulohernandez.paul@mayo.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Angulo
authors.forename: Roberta A
authors.initials: RA
authors.lastname: Jorgensen
authors.forename: Kris V
authors.initials: KV
authors.lastname: Kowdley
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lindor
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D015209:Cholangitis, Sclerosing / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020011:Protective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D012838:Silymarin / Q000008:administration & dosage / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D020011:Protective Agents; D012838:Silymarin