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CompletedNCT04816682SILCOVINT-21Updated Aug 3, 2022

Silymarin in COVID-19 Patients Admitted to Hospital With Elevated Liver Enzymes

A Phase 4 interventional study of Silymarin in Covid19 and Liver Diseases, sponsored by F.D. Roosevelt Teaching Hospital with Policlinic Banska Bystrica. Completed at 2 sites in Slovakia. Open to participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2022-08-03.

Sponsored by F.D. Roosevelt Teaching Hospital with Policlinic Banska Bystrica · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
30
Allocation
Non-randomized
Ages
19 Years and older
Sex
All
01

Study summary

Of patients admitted to an internal medicine ward with internistic diagnosis/es together with COVID-19, substantial proportion has elevated liver enzymes. silymarin / silibinin (milk thistle extract) has been approved as an add-on therapy in various acute and chronic liver diseases; moreover, there is evidence to suggest that it's dual effect (anti-viral and immune-modulatory) might be of benefit in patients infected with SARS-CoV-2. As there is no effective/approved pharmacotherapy for COVID-19, a pilot study with Silymarine in hospitalised patients has been undertaken

Read the detailed description

According to the Bosch-Barrera et al. paper of 2021, silibinin in a daily dose of more than 1000 mg could improve clinical course of COVID-19 by its dual action: 1.direct inhibition of SARS-CoV-2 replication as well as 2.modulation of innate immune response - 2a. its initial (hyper)inflammation as well as 2b. later reparative phase, respectively.

Moreover, the drug is known for its safety and has been approved and widely used in the region for liver diseases. Therefore, the investigation was set out to determine the efficacy of silymarin (compound closely related to Silibinin which is available in the region) in improving the outcome of a liver disease and of COVID-19, respectively.

02

Conditions studied

  • Covid19
  • Liver Diseases

Keywords

  • COVID-19
  • In-hospital mortality
  • Internal medicine
03

Who can participate

Ages eligible
19 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • consecutive, adult, admitted to an internal medicine ward with internistic diagnosis, together with COVID-19, and elevated liver enzymes (any of AST, ALT, GGT, ALP), provided written informed consent

Exclusion criteria

Exclusion Criteria:

  • too sick - terminal illness (no potential for recovery); critical condition on admission requiring immediate tracheal intubation; or any extra-pulmonary organ failure; completely vaccinated against COVID19.
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
30 participants (actual)

Study arms

  • Active comparator
    LAGOSA ARM

    Consecutively admitted patients will be allocated silymarin tablets (150 mg each) T.I.D. 3-2-2

    Drug: Silymarin

  • No intervention
    Control arm

    Consecutive patients with the same inclusion/exclusion criteria as in active arm, hospitalised at the same department before the initiation of the study (historical controls)

Interventions

  • DrugSilymarin

    Silymarine tablets will be provided irrespective of meal by a registered nurse T.I.D

    Also known as: LAGOSA

05

What researchers measure

Primary outcomes

  1. Improvement in the COVID-19 stage of at least 1 point

    Evolution of COVID-19 will be recorded according to a WHO criteria and reported as worsening (including death) / no change / improvement

    Time frame: During the hospital stay - up to around 21 days

  2. Improvement in the activity of aminotranspherases

    Change in the level of ALT

    Time frame: During the hospital stay - up to around 21 days

Secondary outcomes

  1. Improvement in the diabetes control

    Change in the glycemia

    Time frame: During the hospital stay - up to around 21 days

  2. Improvement in the blood inflammatory markers

    Change in C-reactive protein levels

    Time frame: During the hospital stay - up to around 21 days

  3. Improvement in the dyspnea

    Improvement of at least one point in the NYHA classification

    Time frame: During the hospital stay - up to around 21 days

  4. Improvement in the acute kidney injury

    Any improvement in the serum creatinine level

    Time frame: During the hospital stay - up to around 21 days

  5. Improvement in the blood inflammatory markers

    Improvement in the interleukin - 6 level

    Time frame: During the hospital stay - up to around 21 days

06

Study locations

2 sites
  • F.D.Roosevelt Teaching Hospital
    Banska Bystrica, 97401, Slovakia
  • University Hospital Bratislava
    Bratislava, 82101, Slovakia
07

References and documents

Publications

  • Bosch-Barrera J, Martin-Castillo B, Buxo M, Brunet J, Encinar JA, Menendez JA. Silibinin and SARS-CoV-2: Dual Targeting of Host Cytokine Storm and Virus Replication Machinery for Clinical Management of COVID-19 Patients. J Clin Med. 2020 Jun 7;9(6):1770. doi: 10.3390/jcm9061770. PubMed 32517353 ↗

Individual participant data

Plan to share: Yes — Complete dataset will be shared on request under GDPR rules

Supporting information: Study protocol, Sap, Icf, Csr

08

Registry details

Key details

Study ID
NCT04816682
Lead sponsor
F.D. Roosevelt Teaching Hospital with Policlinic Banska Bystrica
Responsible party
Ľubomír Skladaný MD, PhD (Head, Department of Internal Medicine and HEGITO Liver Unit, Principal Investigator, F.D. Roosevelt Teaching Hospital with Policlinic Banska Bystrica) — Principal investigator
First posted
Mar 25, 2021
Start date
Mar 17, 2021
Primary completion
Jun 30, 2021
Completion
Dec 30, 2021
Last update
Aug 3, 2022

Study contacts

Lubomir SKLADANY, MD, PhD
principal investigator · Study Principal Investigator F.D.Roosevelt Teaching Hospital, Banska Bystrica, Slovakia

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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