Effect of Silymarin on Hepatic Complications Caused by Methotrexate and its Analgesic Effects in Patients with Rheumatoid Arthritis

Abstract

Background and Aim: Methotrexate is an important drug for treatment of rheumatoid arthritis (RA) but is associated with adverse side effects on liver. In this study we evaluated the effect of silymarin on methotrexate induced hepatotoxicity and its analgesic effects in the patients taking this drug. Materials and Methods: This study inclouded 58 patients with RA. Patients who had been treated with 2.5 mg methotrexate three times a week for six months were randomly divided into two groups of A and B. Group A received methotrexate and group B treated with 280 mg of silymarin tablets daily (two doses for 2 months) in addition to methotrexate. At baseline (before tests) and after two months, both groups completed the VAS (Visual Analogue Scale) questionnaire and Cr (Creatinine), BUN (Blood Urea Nitrogen), ESR (Erythrocyte Sedimentation Rate), Hemoglobin, WBC (white blood cell), PLT (Platelet) and the liver tests including ALT (Alanine Transaminase) and AST (Aspartate Aminotransferase) were evaluated. We used t-test for data analysis. Results: In the group B, ALT, AST and ESR, Cr and BUN decreased significantly. Also clinical signs of pain which were indicative of pain intensity were decreased. Conclusion: Use of silymarin in the patients with RA reduced liver enzymes, liver toxicity and renal complications, which may be due to its antioxidant and cell membrane stabilization properties.

Keywords

• methotrexate
• silymarin
• liver complications
• alanine transferase
• aspartate transferase