الفهرس 
Osteoporosis
Anatomy and physiologyOnly 14 pages are availabe for public view
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Abstract
This is the first study to be done on postmenopausal females in order
to evaluate the clinical outcome of combination therapy of silymarin and
alendronate in treatment of postmenopausal osteoporosis compared to the
monotherapy of each.
Drugs derived from natural products are known to have fewer side
effects than pharmaceutical drugs and so it was of significance to develop
natural alternative therapies for preventing postmenopausal or senile
osteoporosis. Numerous studies have shown that natural products and
dietary components such as Silymarin have positive effects on bone
remodeling particularly by inhibiting bone resorption.
The present study is an early attempt to measure the effect of
silymarin on postmenopausal osteoporotic women. In total, 75 patients
with postmenopausal osteoporosis were included only 69 of them
completed the study. The population of the study was categorized into
three groups: group 1 (n=22) where patients received 70 mg Alendronate
once weekly for two years, group 2 (n=23) where patients received 140
mg Silymarin three times daily for two years and group 3 (n=24) where
patients received 35 mg Alendronate once weekly and 140 mg Silymarin
three times daily for two years. Then DXA scans were done after one
year of treatment and after two years of treatment. Although the results in
the silymarin group are significantly less than in alendronate group and
combined therapy group yet they are promising as the patients received
silymarin showed improvement in the mean T-scores of spine, femur and
wrist where the P-values when comparing the percentage change of Tscores of the three groups after two years of treatment are as follows
(pspine=0.000, pfemur=0.000, pwrist=0.033). Compliance to silymarin therapy
was good as the drug is palatable and has no gastric side effects as
compared to the known side effects of alendronate therapy.
Combining both Silymarin and alendronate therapy yielded better
results than treatment with Silymarin alone yet these results do not
conclude the synergestic effect of the combination as previous studies
have shown improvement of bone mineral density in patients receiving 35
mg weekly dose of alendronate (Marjorie et al., 2003). Another study comparing two patient groups , one receiving 35mg weekly alendronate
and another group receiving 35mg weekly alendronate combined with
Silymarin is necessary to prove this hypothesis.
On the contrary this study is a very short term study and has been
conducted on a limited group of patients. Although we tried to consider
patient variables such as age, weight, and race yet a lot of other factors
could possibly affect the outcome as number of pregnancies, genetic
factors, level of activity and exposure to sunlight.
To reach a conclusion that silymarin is an efficient drug to treat
postmenopausal osteoporosis requires further studies with longer time
frames, dose assessment and larger patient groups with assessment of
patients variables like bone turnover markers, liver functions, kidney
functions and thyroid functions.