2005/09/12 by Andrea Rambaldi, Bradly P. Jacobs, Gaetano Iaquinto +1 · 117 citations
Medicine · Pharmacology, Toxicology and Pharmaceutics · Biochemistry, Genetics and Molecular Biology · #Silymarin and Mushroom Poisoning #Drug-Induced Hepatotoxicity and Protection #Plant Toxicity and Pharmacological Properties #Medicine #Alcoholic hepatitis #Internal medicine #Randomized controlled trial #Placebo #Relative risk #Alcoholic liver disease #Liver disease #Gastroenterology #Clinical trial #Adverse effect #Meta-analysis #Confidence interval #Pathology #Cirrhosis
paper · doi:10.1111/j.1572-0241.2005.00262.x
published in The American Journal of Gastroenterology 100(11), 2583-2591 (Lippincott Williams & Wilkins)
openalex publication_date 2005/09/12 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
OBJECTIVES: Our objectives were to assess the beneficial and harmful effects of milk thistle (MT) or MT constituents versus placebo or no intervention in patients with alcoholic liver disease and/or hepatitis B and/or C liver diseases. METHODS: Randomized clinical trials studying patients with alcoholic and/or hepatitis B or C liver diseases were included (December 2003). The randomized clinical trials were evaluated by components of methodological quality. RESULTS: Thirteen randomized clinical trials assessed MT in 915 patients with alcoholic and/or hepatitis B or C liver diseases. The methodological quality was low: only 23% of the trials reported adequate allocation concealment and only 46% were considered double blind. MT versus placebo or no intervention for a median duration of 6 months had no significant effects on all-cause mortality (relative risk (RR) 0.78, 95% confidence interval (CI) 0.53-1.15), complications of liver disease, or liver histology. Liver-related mortality was significantly reduced by MT in all trials (RR 0.50, 95% CI 0.29-0.88), but not in high-quality trials (RR 0.57, 95% CI 0.28-1.19). MT was not associated with a significantly increased risk of adverse events. CONCLUSIONS: Based on high-quality trials, MT does not seem to significantly influence the course of patients with alcoholic and/or hepatitis B or C liver diseases. MT could potentially affect liver injury. Adequately conducted randomized clinical trials on MT versus placebo may be needed.