title: [Effect of silymarin on liver health and quality of life. Results of a non-interventional study].
abstract: BACKGROUND
  Many drugs are known to have hepatotoxic side effects. The effect of silymarin on liver function and liver-injury-impaired quality of life under daily practice conditions in patients with elevated values of liver enzymes was evaluated in the present non-interventional study.
  
  
  METHODS
  Patients with drug-induced elevated aminotransferase levels and indication for silymarin (Legalon forte) treatment for 2 to 3 months were documented prospectively over 4 months. At baseline, after 2 and 4 months, respectively, the following parameters were documented: alanine transaminase (ALT), aspartate transaminase (AST), γ-glutamyltransferase (GGT), alkaline phosphatase, total bilirubin, presence of liver-related skin symptoms and discoloured urine, severity of liver-related symptoms and quality of life.
  
  
  RESULTS
  In total, 190 patients (53.2% male, median age 60.0 years [range 19-81]) from 48 centres participated in the non-interventional study. Among potentially hepatotoxic drugs, analgesics/anti-inflammatory drugs were used most frequently (45.8%). These drugs have been administered for a median period of 2.8 years (range 0.0-26.1). At baseline, all patients had elevated levels of ALT, AST or GGT. Fatigue, flatulence, upper abdominal discomfort, lethargy, and joint complaints were the most severe liver-related symptoms and prevalent in over 62% of patients. Quality of life was affected in 88.7% of patients. Significant reductions were achieved in all documented laboratory parameters (p < 0.001), leading to marked improvement in liver-related symptoms and increased quality of life already after 2 months. The percentage of patients with liver enzymes in the normal range increased considerably within 4 months. No adverse drug reactions were observed.
  
  
  CONCLUSIONS
  Silymarin is a safe and efficacious treatment option for patients with elevated liver enzymes. A benefit in terms of liver-related symptoms as well as quality of life and performance was demonstrated already after 2 months of treatment.
authors.forename: Anton
authors.initials: A
authors.lastname: Gillessen
authors.forename: Wolfgang A
authors.initials: WA
authors.lastname: Herrmann
authors.forename: Markus
authors.initials: M
authors.lastname: Kemper
authors.forename: Helmut
authors.initials: H
authors.lastname: Morath
authors.forename: Klaus
authors.initials: K
authors.lastname: Mann
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056486:Chemical and Drug Induced Liver Injury / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006519:Hepatitis, Alcoholic / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012838:Silymarin / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D012838:Silymarin