Phase I Trial of Silymarin for Chronic Liver Diseases

Hepatitis C Clinical Trial

— SyNCH  

Official title:

Single and Multiple Dose Escalation Phase I Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of Orally Administered Silymarin (Legalon) in Non-Cirrhotic Subjects With Chronic Hepatitis C or Non-Alcoholic Fatty Liver Disease

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00389376
• Other study ID #: U01AT003566-01
• Secondary ID: NIH grant # U01-
• Status: Completed
• Phase: Phase 1
• First received: October 16, 2006
• Last updated: February 15, 2008
• Start date: November 2006
• Est. completion date: February 2008

Study information

• Verified date: February 2008
• Source: National Center for Complementary and Integrative Health (NCCIH)
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Federal GovernmentUnited States: Institutional Review BoardUnited States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine the safety and tolerability of different dosages of silymarin on subjects with Hepatitis C or Non-Alcoholic Fatty Liver Disease.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 56
• Est. completion date: February 2008
• Est. primary completion date: January 2008
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion criteria

Subjects will be eligible for enrollment in this study if they meet the following criteria:

• Males or females; age at least 18 years at screening

• Abnormal ALT > 65 IU/L (ie, approximately 1.5 x upper limit of normal)

• Negative urine pregnancy test (for women of childbearing potential) documented within the 24-hour period prior to the first dose of silymarin. Females of childbearing potential must be using two reliable forms of effective contraception during the study (while on drug and during follow-up)

• Hepatitis C virus (HCV) patients

• Previous treatment with any interferon-based therapy without sustained virological response.

• Serum HCV RNA above quantifiable level of detection by the assay, within 1 year of screening and after the end of therapy

• No antiviral therapy for at least 6 months prior to screening visit

• Nonalcoholic fatty liver disease (NAFLD) patients:

• Liver biopsy compatible with NAFLD within 3 years of screening

• Absence of other liver diseases by serological screening (anti-HCV, HBsAg), historical serological data from within 3 years of screening is acceptable.

• Before entering the study, subjects must agree not to consume alcohol for 48 hours prior to PK sampling days or while on study.

Exclusion criteria

Subjects with any of the following will not be eligible for participation:

• Use of silymarin or other milk thistle preparations within 30 days of screening

• Use of other antioxidants such as vitamin E, vitamin C, glutathione, alpha-tocopherol, within 30 days of screening. A multivitamin at standard doses will be allowed.

• Allergy/sensitivity to milk thistle or its preparations

• Use of silymarin or other antioxidants (as above) during the screening period.

• Use of warfarin, metronidazole or chronic use of acetaminophen greater than two gram per day

• Previous liver biopsy that demonstrated presence of cirrhosis

• Previous liver biopsy that demonstrated greater than or equal to 15% steatosis or evidence of steatohepatitis for HCV cohort

• Positive test for anti-HIV or HBsAg within 3 years of screening

• Positive urine drug screen for drugs of abuse at screening

• Alcohol consumption of more than one drink or equivalent (>12 grams) per day. Patients who consumed more than this in the past must have maintained a level 12 grams or less per day of alcohol consumption for at least six months prior to screening.

• History of other chronic liver disease, including metabolic diseases, documented by appropriate test(s)

• Women with ongoing pregnancy or breast-feeding, or contemplating pregnancy

• Platelet count <130,000 cells/mm3.

• Serum creatinine level >1.5 times the upper limit of normal at screening, or CrCl 60 cc/min, or currently on dialysis. The creatinine clearance (CrCl) will be calculated according to Cockcroft-Gault.

• Evidence of alcohol or drug abuse within 6 months prior to screening

• Evidence of decompensated liver disease defined as any of the following: serum albumin <3.2 g/dl, total bilirubin > 1.5 mg/dl, or PT/INR > 1.3 times normal at screening, or history or presence of ascites or encephalopathy, or bleeding from esophageal varices

• History or other evidence of severe illness or any other conditions that would make the patient, in the opinion of the investigator, unsuitable for the study (such as poorly controlled psychiatric disease, coronary artery disease, or active gastrointestinal conditions that might interfere with drug absorption)

• History of immunologically mediated disease (e.g., inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune hepatitis, autoimmune hemolytic anemia, severe psoriasis, rheumatoid arthritis) that could affect inflammatory biomarkers

• History of solid organ or bone marrow transplantation

• History of thyroid disease poorly controlled on prescribed medications

• Use of oral steroids within 30 days prior to screening

• Concurrent medications that are CYP3A4 inducers

• Inability or unwillingness to provide informed consent or abide by the study protocol

Study Design

Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Basic Science

Related Conditions & MeSH terms

• Fatty Liver
• Hepatitis
• Hepatitis C
• Liver Diseases
• Non-Alcoholic Fatty Liver Disease

Intervention

Drug:
• Placebo
Placebo
• Silymarin
140 mg every 8 hours
• Silymarin
280 mg single dose
• Silymarin
280 mg single dose + every 8 hours
• Silymarin
560 mg single dose + every 8 hours
• Silymarin
560 mg single dose + every 8 hours
• Silymarin
280 mg every 8 hours
• Silymarin
700 mg single dose + every 8 hours

Locations

Country	Name	City	State
United States	Beth Israel Deaconess Medical Center	Boston	Massachusetts
United States	The University of North Carolina at Chapel Hill	Chapel Hill	North Carolina
United States	Thomas Jefferson University	Philadelphia	Pennsylvania
United States	University of Pennsylvania	Philadelphia	Pennsylvania
United States	University of Pittsburgh, Graduate School of Public Health	Pittsburgh	Pennsylvania

Sponsors (2)

Lead Sponsor	Collaborator
National Center for Complementary and Integrative Health (NCCIH)	National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Adverse events		10 days	Yes