Sylimarin Versus Essential Phospholipids in Metabolic Associated Steatotic Liver Disease (MASLD) – A Prospective Comparative Randomized Trial

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an entity with a growing incidence but only a few pharmacological options.In Romania, the prevalence of MASLD has been increasing, while that of viral hepatitis has been decreasing.The purpose of this study is to compare two supplements for the treatment of MASLD.Methods: Between January 2020 and May 2022, 90 patients with MASLD were randomized to receive either silymarin 150 mg b.i.d (45 subjects) or essential phospholipids (EPLs) 825 mg b.i.d.(45 subjects) for six months.All study participants received recommendations for lifestyle and diet modifications.Assessment of the severity of steatosis and liver fibrosis was performed using FibroScan® with controlled attenuated parameter (CAP) at the beginning and end of treatment.Results: A total of 68 patients completed the trial.The two groups were statistically comparable in terms of clinical, biological and FibroScan® parameters.Aspartate transferase (AST) decreased from a median of 40 to 28 IU/L in the EPL arm (compared to 25→25.5 IU/L in the silymarin arm) (p-value=0.11) and alanine 2024; 19(1): 9-16