Author Affiliations: Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill (Dr Fried; firstname.lastname@example.org); Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, Chapel Hill, North Carolina (Dr Hawke); and Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia (Dr Reddy).
In Reply: The presence of conflicting data regarding the efficacy of silymarin was a prime motivator for conducting detailed phase 1 and phase 2 clinical trials of oral silymarin in a well-characterized population with chronic hepatitis C.1-3 We agree that the reports of intravenous silibinin succinate for HCV are intriguing and deserve further inquiry; however, they are not analogous to studies of the oral formulation.4
Fried MW, Hawke RL, Reddy KR. Treatment With Silymarin for Hepatitis C Virus—Reply. JAMA. 2012;308(18):1856–1857. doi:10.1001/jama.2012.13744
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