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Evidence summaries

Milk Thistle for Alcoholic and/or Hepatitis B or C Virus Liver Diseases

Milk thistle may not have significant effects of on mortality or complications of liver diseases in patients with alcoholic and/or hepatitis B or C liver diseases based on the results of high-quality trials. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 13 studies with a total of 915 subjects. Milk thistle versus placebo or no intervention had no significant effect on mortality (RR 0.78, 95% CI 0.53 to 1.15), complications of liver disease (RR 0.95, 95% CI 0.83 to 1.09), or liver histology. Liver-related mortality was significantly reduced by milk thistle in all trials (RR 0.50, 95% CI 0.29 to 0.88), but not in high-quality trials (RR 0.57, 95% CI 0.28 to 1.19). Milk thistle was not associated with a significantly increased risk of adverse events (RR 0.83, 95% CI 0.46 to 1.50).

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment, lack of appropriate blinding).

    References

    • Rambaldi A, Jacobs BP, Gluud C. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. Cochrane Database Syst Rev 2007 Oct 17;(4):CD003620. [PubMed]

Primary/Secondary Keywords