RecruitingPhase 2NCT06213857

Beneficial Effect of Silymarin in Ulcerative Colitis

Clinical Study Evaluating the Possible Beneficial Effect of Silymarin in Patients With Ulcerative Colitis


Sponsor

Tanta University

Enrollment

44 participants

Start Date

Feb 1, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this clinical trial is to evaluate the possible beneficial effect of silymarin in Ulcerative Colitis adult patients receiving mesalamine. This is trial that will be conducted on 44 adult patients with Ulcerative Colitis. Patients will be enrolled after obtaining an informed consent from them or their guardians. Patients will be recruited from Rajhy Hospital Outpatient Clinics and Health Insurance Outpatient Clinics at Mabarra Hospital in Assiut, Egypt. The patients will be randomized based on hospital admission days into two groups: * Group Ⅰ (Control group): 22 patients will receive Mesalamine (2g/day) + Azathioprine (50mg/day) for 3 months. * Group Ⅱ (Silymarin group): 22 patients will receive Mesalamine (2g/day) + Azathioprine (50mg/day) + Silymarin (140 mg/day) for 3 months. The primary outcome will be clinical improvement defined as a 2 point or more decrease in the Mayo score from baseline. The secondary outcomes will be the change in the level of fecal calprotectin, superoxide dismutase and TNF-α.


Eligibility

Min Age: 18 YearsMax Age: 65 Years

Inclusion Criteria4

  • Adults of both sexes aged from 18 years to 65 years.
  • Adults with normal kidney and liver functions.
  • Patients who sign the consent and willing to participate in the study.
  • Patients with UC according to American College of Gastroenterology Clinical Guidelines for diagnosis Ulcerative Colitis having clinical signs and symptoms with a completed medical workup, colonoscopy, pathological and laboratory data confirming UC

Exclusion Criteria7

  • Previous hypersensitivity or anaphylactic reaction to silymarin.
  • Significant renal and hepatic impairment.
  • Patients who refuse to participate.
  • Pregnant women, breastfeeding women and smokers.
  • Patients taking corticosteroids or biological therapy.
  • Patients taking any other antioxidants.
  • Patients having other concomitant diseases where oxidative stress is involved in the etiology such as chronic liver disease, pulmonary infection.

Interventions

DIETARY_SUPPLEMENTSilymarin

Silymarin (milk thistle), an extract obtained from Silybum marianum seeds containing a complex of flavonolignans with a potent intracellular antioxidant property. The first usage of Milk thistle was for its hepatoprotective and antioxidant activities, but in the recent years it has been used to control of immune based murine colitis by healing of bowel histology and reduction of bowel inflammatory cytokines especially TNF-α, interleukin-1β (IL-1β), and nuclear factor κB (NF-κB). Silymarin has anti-viral, immunomodulation, anti-inflammatory effects as well as antioxidant properties by scavenging free radicals and increasing the glutathione concentrations, protective and wound healing effects. It increases the gene expression of antioxidant enzymes and the number of the most important protection mechanisms against free-radicals damage containing superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase.

DRUGMesalamine

A 5-aminosalicylic acid compound used in the treatment of mild to moderate ulcerative colitis, with high rates of efficacy in induction and maintenance of remission.

DRUGAzathioprine

An immunosuppressive medication that is used for the treatment of inflammatory bowel disease (Crohn's disease and ulcerative colitis). It works by decreasing the activity of the body's immune system so it will not attack itself.


Locations(2)

Mabarra Hospital

Asyut, Egypt

Rajhy Hospital

Asyut, Egypt

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NCT06213857


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