Anti-inflammatory activity of silymarin [milk thistle extract] in patients with knee osteoarthritis. A comparative study with piroxicam and meloxicam – Source: Saudi Medical Journal, Jan 2009

[Note: Considerable clinical research suggests that silymarin, a well-tolerated flavonoid extract of the humble milkweed seed, supports the body’s natural free-radical scavenging and anti-inflammatory activities – with a focus on its ability to support healthy liver function/detoxification.]

Objective: To evaluate the anti-inflammatory effect of Silymarin [milk thistle extract] in patients with knee osteoarthritis (OA) in comparison with piroxicam and meloxicam [non-steroidal anti-inflammatory drugs used to treat tenderness, swelling and pain of osteo and rheumatoid arthritis].

Methods: A double-blind clinical trial was performed at the Department of Rheumatology, Baghdad Teaching Hospital, Baghdad, Iraq during the period from October 2004 to September 2005, in which 220 patients – 79 males and 141 females- with painful knee osteoarthritis were randomized into 5 groups, treated with either:

• Silymarin [milk thistle extract] 300mg/day,

• Piroxicam 20mg/day,

• Meloxicam 15mg,

• Or a combination of silymarin with piroxicam or meloxicam.

Serum levels of interleukin-1 alpha, interleukin-8, and the complement proteins C3 and C4 were assessed at zero time, and after 8 weeks. [Markers of immune activity involving inflammation and bone-joint degeneration.]


• Silymarin reduces significantly serum levels of IL-1 alpha and IL-8, C3 and C4 after 8 weeks compared to the pre-treatment levels.

• Piroxicam showed no significant reduction in IL-1 alpha levels, while IL-8 decreased significantly, compared to pre-treatment value.

• Meloxicam elevates serum levels of IL-1 alpha significantly, while IL-8 did not significantly change compared to the pre-treatment value.

• Piroxicam or meloxicam produced slight, non-significant increase in serum levels of complement proteins after the 8-week treatment period.

• Adjunct use of silymarin with piroxicam results in significant reduction in both cytokines IL-1 alpha and IL-8, and serum levels of C3 and C4.

• However, its [silymarin’s] adjunct use with meloxicam did not reveal any significant changes in this respect.

Conclusion: Silymarin reduces the elevated levels of interleukins and complement proteins, when used alone, or in combination with NSAIDs for the treatment of knee OA.

Source: Saudi Medical Journal, Jan 2009;30(1):98-103. PMID: 19139781, by Hussain SA, Jassim NA, Numan IT, Al-Khalifa II, Abdullah TA. Department of Pharmacology and Toxicology, College of Pharmacy, University of Baghdad, Baghdad, Iraq. [E-mail:]

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