COMPARING THE EFFECTS OF ROSUVASTATIN AND SILYMARIN ON LIPID LEVELS AS MONOTHERAPY OR COMBINATION THERAPY FOR THE TREATMENT OF HYPERLIPIDEMIA

Abstract

Background: Hyperlipidemia is defined as the elevation in the fasting concentration of total cholesterol along with Triglycerides and LDL. Increase in cholesterol levels and triglyceride level leads to atherosclerosis which is intimal thickening, lipid accumulation and calcification in the arteries causing endothelial dysfunction and can result in cardiovascular diseases. Rosuvastatin, a HMG CoA reductase inhibitor have been approved as a first line Drug for Hyperlipidemia and significantly decreases high levels of cholesterol, TG and LDL. Silymarin, a traditional herbal remedy obtained from the seed of silybum marianum which is a milk thistle plant. is affiliated with alteration of membrane lipid by interfering with the secretion and uptake of lipoproteins Objective: To evaluate the effects of silymarin alone or in combination with rosuvastatin on elevated total cholesterol, Triglycerides, high levels of Low Density lipoproteins and low levels of High Density Lipoproteins. Subjects, Materials and Methods: This randomized, open clinical trial was conducted in 90 Hyperlipidemic males and females above 40 years of age. They were allocated into three groups and the recruitment of patient was done at OPD of National Medical Center. 90 subjects were randomly allocated in three groups comprising of 30 subjects in each group by a computer allocated balloting randomization. The Group A subjects were given Tablet rosuvastatin 10mg OD alone. The Group B subjects were given Tablet Rosuvastatin 10mg OD and Tablet Silymarin 200mg 1× BD. The Group C subjects were advised Tablet Silymarin 200mg 1×BD alone for the period of 3 months. Baseline investigations FLP, LFTS and CPK were done at week 0 and at week 12. There were total three visits of patients, at week 0, at week 6 and at the end of week 12. At week 0 patients were asked to read consent form and sign it, they were assessed for anthropometric measurements, evaluation form was filled with personal and laboratory data and were advised to take low carbohydrate and low fat diet. At week 6 the patients were called to check for any adverse symptoms and check their compliance and after 12 weeks patients were called along with xi the laboratory investigation reports. At this time their anthropometric measurements were also checked and documented. Conclusion: Silymarin shows great potential in decreasing lipid levels of the blood when used alone and in combination with rosuvastatin. It has also shown great results in decreasing liver enzymes when used alone or in combination with rosuvastatin. The results of this study can further be evaluated with bigger sample size.