Probe • Vol LXII • No. 3 • May–Aug 2023 • 3 Liv.52 DS in the Management of Statin-Induced Liver Injury levels was observed in the Liv.52 DS tablet + atorvastatin group, after 3 months (Figures 1–3). The differences between the groups in terms of physical examination parameters (such as the skin, general health, body temperature and weight, and liver size) and subjective signs (such as coating of the tongue, loss of appetite, nausea and vomiting, and pain and discomfort in the right hypochondrium) were insignificant. Likewise, no significant differences were noticed in the other biochemical and hematological parameters between the groups. Conclusion The results of this study show that in the atorvastatin-alone group, there was a significant increase in the mean values of SGPT, SGOT, and total bilirubin after 3 months, whereas no such increase in SGPT, SGOT, and total bilirubin was observed in the Liv.52 DS tablet + atorvastatin group, after 3 months of therapy. Also, there were no significant differences between the groups in terms of physical examination and subjective signs at the end of the treatment period. The hepatoprotective effect of Liv.52 DS tablet may be attributed to the synergistic action of its constituent herbs such as Capparis spinosa, Cichorium intybus, Solanum nigrum, Cassia occidentalis, Terminalia arjuna, Achillea millefolium, and Tamarix gallica. Thus, this study shows that Liv.52 DS tablet has hepatoprotective effect against statin-induced liver damage. Summary • Fifty patients (of both sexes) on antihyperlipidemic therapy with statins were included in the study. • The patients were randomized into 2 groups; Liv.52 DS tablet + atorvastatin tablet (1 tablet each, BID) group and atorvastatin-alone (1 tablet, BID) group, for 3 months. • Symptomatic evaluation, clinical examination, liver function tests, hemogram, and other biochemical tests were performed at monthly intervals for 3 months. • A significant increase in the mean values of SGPT, SGOT, and total bilirubin levels was observed in the atorvastatin-alone group, after 3 months. • No increase in the SGPT, SGOT, and total bilirubin levels was observed in the Liv.52 DS tablet + atorvastatin group, after 3 months. • The study results confirm the hepatoprotective effect of Liv.52 DS against statin-induced liver damage. Figure 1. A Comparison of the Increase in the SGPT Level in the Liv.52 DS + Atorvastatin and Atorvastatin-Alone Groups SGPT, serum glutamic pyruvic transaminase. 20 120 100 80 60 40 0 SGPT, IU/L a a Liv.52 DS + Atorvastatin Month 1 Month 2 Month 3 Atorvastatin alone aP < .01 compared with month-1 value Month 1 Month 2 Month 3 Figure 2. A Comparison of the Increase in the SGOT Level in the Liv.52 DS + Atorvastatin and Atorvastatin-Alone Groups SGOT, serum glutamic oxaloacetic transaminase. 20 120 100 80 60 40 0 SGOT, IU/L a a Liv.52 DS + Atorvastatin Month 1 Month 2 Month 3 Atorvastatin alone aP < .01 compared with month-1 value Figure 3. A Comparison of the Increase in the Total Bilirubin Level in the Liv.52 DS + Atorvastatin and Atorvastatin-Alone Groups 0.2 1.4 1.2 1.0 0.8 0.6 0.4 0 Total Bilirubin, g/dL a Liv.52 DS + Atorvastatin Atorvastatin alone aP < .01 compared with month-1 value
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