Effect of silymarin for the prevention of drug-induced liver injury in tuberculosis patients
Abstract
To evaluate the effect of silymarin for the prevention of antituberculosis drug-induced liver injury 307 new tuberculosis patients were enrolled to the retrospective cohort study. The patients of silymarin group (n = 204) received silymarin in a dose of 105 mg per day from the start of anti-tuberculosis treatment; patients of control group (n = 103) received only anti-tuberculosis drugs. The follow-up period were equal to the duration of intensive phase of anti-tuberculosis treatment. Drug-induced liver injury was registered in 20.1% (41/204) and 33.0% (34/103) in silymarin and control groups, respectively (р = 0.017, RR 1.64, 95%CI 1.11–2.42). The effect of silymarin was different in groups of high and low individual risk of drug-induced liver injury defined by validated risk assessment scale. Only in patients with high individual risk the rate of drug-induced injury in silymarin group was significantly low: 23.2% (13/56) vs 65.8% (25/38) in control group (р < 0.001, RR = 2.83, 95%CI 1.67–4.81). In patients with low individual risk silymarin had no protective effect (19.2% and 12.8% cases of druginduced injury in silymarin and control groups, p = 0,320). So, silymarin preventive use indicated only for TB patients with high individual risk of drug-induced liver injury.
About the Authors
D. A. Ivanova
ГБУЗ города Москвы «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»
Russian Federation
Russian Federation
Д. Кудлай
ФГБОУ ДПО «Институт повышения квалификации» ФМБА России
Russian Federation
Russian Federation
S. E. Borisov
ГБУЗ города Москвы «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»
Russian Federation
Russian Federation
Н. Николенко
ГБУЗ города Москвы «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»
Russian Federation
Russian Federation
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Review
For citations:
Ivanova D.A., , Borisov S.E., Effect of silymarin for the prevention of drug-induced liver injury in tuberculosis patients. Tuberculosis and socially significant diseases. 2017;(4):28-33. (In Russ.)
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