The herbal supplement was found to be effective inreducing the low-density lipoprotein (LDL) cholesterol level among 62 patients with hyperlipidemia and a history of discontinuation of statin therapy due to myalgias.
“Red yeast rice and therapeutic lifestyle change decrease LDL cholesterol level without increasing CPK or pain levels and may be a treatment option for dyslipidemic patients who cannot tolerate statin therapy,” the researchers concluded.
“Given our positive results, our approach may provide a therapeutic lipid-lowering option for the large cohort of patients with a history of SAM (statin-associated myalgias).”
In the randomized, controlled trial, patients were assigned either 1800 mg of red rice twice daily or placebo for 24 weeks. All patients were concomitantly enrolled in a 12-week therapeutic lifestyle change programme.
LDL cholesterol levels were measured at baseline, week 12, and week 24 and secondary outcomes included total cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride, liver enzyme, and creatinine phosphokinase (CPK) levels; weight; and Brief Pain Inventory (BPI) score.
For the 31 patients in the red yeast rice group, LDL cholesterol decreased by 1.11 mmol/L (43 mg/dL) from baseline at week 12 and by 0.90 mmol/L (35 mg/dL) at week 24.
In the placebo group, LDL cholesterol decreased by 0.28 mmol/L (11 mg/dL) at week 12 and by 0.39 mmol/L (15 mg/dL) at week 24.
While the researchers acknowledged that the study was small, single-site, short in duration and focused on laboratory measures, they stated the LDL level was significantly in the red rice group.
Levels of HDL cholesterol, triglyceride, liver enzyme, or CPK; weight loss; and BPI did not change significantly.
The researchers called for more study, especially those taking red rice supplements for more than six months, and said many questions remained unanswered.
- Does red yeast rice reduce the incidence of myalgias when directly compared with statin therapy?
- Is red yeast rice effective in patients with previous SAM who are not enrolled in a lifestyle change program?
- Did the therapeutic lifestyle change program alone play a positive role in decreasing the risk for recurrent myalgias in our cohort (for example, through improved mood or the role of exercise and weight loss)?
Source: Annals of Internal Medicine
‘Red Yeast Rice for Dyslipidemia in Statin-Intolerant Patients: A Randomized Trial’
Authors: David J. Becker, MD; Ram Y. Gordon, MD; Steven C. Halbert, MD; Benjamin French, PhD; Patti B. Morris, RD; and Daniel J. Rader, MD