Red Yeast Rice for the Treatment of Dyslipidemia

Current Atherosclerosis Reports

Volumn 17, Issue 4, 2015, Pages

  Burke, Frances M ^a  

^a UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

Dyslipidemia; HMG CoA reductase inhibitor; Hypercholesterolemia; Lovastatin; Mevacor; Monacolin K; Red yeast rice; Statin associated myalgia (SAM); Xuezhikang

Indexed keywords

CHOLESTIN; CITRININ; LOW DENSITY LIPOPROTEIN CHOLESTEROL; MEVINOLIN; PLACEBO; PRAVASTATIN; SIMVASTATIN; TRIACYLGLYCEROL; XUEZHIKANG; BIOLOGICAL PRODUCT; HERBACEOUS AGENT; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR;

CARDIOVASCULAR MORTALITY; DRUG EFFICACY; DRUG MECHANISM; DRUG SAFETY; DRUG STRUCTURE; DRUG TOLERABILITY; DYSLIPIDEMIA; GASTROINTESTINAL SYMPTOM; GOVERNMENT REGULATION; HEART DEATH; HEART INFARCTION; HUMAN; HYPERCHOLESTEROLEMIA; MUSCLE SPASM; MYALGIA; NONHUMAN; OUTCOME ASSESSMENT; REVIEW; SECONDARY PREVENTION; TREATMENT DURATION; DIET SUPPLEMENTATION; DRUG APPROVAL; DYSLIPIDEMIAS; FOOD AND DRUG ADMINISTRATION; UNITED STATES;

BIOLOGICAL PRODUCTS; DIETARY SUPPLEMENTS; DRUG APPROVAL; DRUGS, CHINESE HERBAL; DYSLIPIDEMIAS; HUMANS; HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS; UNITED STATES; UNITED STATES FOOD AND DRUG ADMINISTRATION;

EID: 84924110181     PISSN: 15233804     EISSN: 15346242     Source Type: Journal    
DOI: 10.1007/s11883-015-0495-8     Document Type: Review

References (29)

1. Gordon RY, Becker DJ. The role of red yeast rice for the physician. Curr Atheroscler Rep. 2011;13(1):73–80.
2. Cunningham E. Is red yeast rice safe and effective for lowering cholesterol? J Am Diet Assoc. 2011;111(2):324.
3. Musselman ME, Pettit RS, Derenski KL. A review and update of red yeast rice. J Evid Based Complement Alternat Med. 2012;17(1):33–9.
4. Childress L, Gay A, Zargar A, Ito MK. Review of red yeast rice content and current food and drug administration oversight. J Clin Lipidol. 2013;7:117–22.
5. ConsumerLab.com. Red yeast rice supplements review. http://www.consumerlab.com/reviews/Red-Yeast-Rice-Supplements-Review/Red_Yeast_Rice. Accessed November 7, 2014.
6. Ma J, Li Y, Ye Q, Li J, Hua Y, Ju D, et al. Constituents of red yeast rice, a traditional Chinese food and medicine. J Agric Food Chem. 2000;48:5220–5.
7. Becker DJ, Gordon RY, Morris PB, Yorko J, Gordon YJ, Li M, et al. Simvastatin vs therapeutic lifestyle changes and supplements: randomized primary prevention trial. Mayo Clin Proc. 2008;83(7):758–64.
8. Heber D, Yip I, Ashley JM, Elashoff DA, Elashoff RM, Go VL. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr. 1999;69:231–6.
9. Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998;279(20):1615–22.
10. Nijjar P, Burke F, Bloesch A, Rader D. Role of dietary supplements in lowering low-density lipoprotein cholesterol: a review. J Clin Lipidol. 2010;4:248–58.
11. Chen CH, Jc Y, Uang YS, Lin CJ. Improved dissolution rate and oral bioavailability of lovastatin in red yeast rice products. Int J Pharm. 2013;444(1–2):18–24.
12. Lin CC, Li TC, Lai MM. Efficacy and safety of Monascus purpureus Went rice in subjects with hyperlipidemia. Eur J Endocrinol. 2005;153(5):679–86.
13. Verhoeven V, Lopez Hartmann M, Remmen R, Wens J, Apers S, Van Royen P. Red yeast rice lowers cholesterol in physicians—a double blind, placebo controlled randomized trial. BMC Complement Altern Med. 2013;13:178–84.
14. Moriarty PM, Roth EM, Karns A, Ye P, Zhao SP, Liao Y, et al. Effects of Xuezhikang in patients with dyslipidemia: a multicenter, randomized, placebo-controlled study. J Clin Lipidol. 2014;8(6):568–75. This is the first multicenter trial conducted in both the US and China evaluating the efficacy of Xuezhikang (XZK), a purified extract of red yeast rice, to treat dyslipidemia. It randomized 116 patients (53 % white, 37 % Asian) to 1200 or 2400 mg XZK or placebo and followed for 12 weeks. Treatment with XZK resulted in significant reductions in both non-HDL-C and LDL-C compared with placebo. Doubling the dose after 4 weeks resulted in an additional reduction in LDL-C.
15. Lu Z, Kou W, Du B, Wu Y, Zhao S, Brusco OA, et al. Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol. 2008;101(12):1689–93.
16. Li JJ, Lu ZL, Kou WR, Chen Z, Wu Y, Yu XH, et al. Beneficial impact of Xuezhikang on cardiovascular events and mortality in elderly hypertensive patients with previous myocardial infarction from the China Coronary Secondary Prevention Study (CCSPS). J Clin Pharmacol. 2009;49(8):947–56.
17. Li Y, Jiang L, Jia Z, Xin W, Yang S, Yang Q, et al. A meta-analysis of red yeast rice: an effective and relatively safe alternative approach for dyslipidemia. PLoS One. 2014;9(6):e98611.
18. Halbert SC, French B, Gordon RY, Farrar JT, Schmitz K, Morris PB, et al. Tolerability of red yeast rice (2400 mg twice daily) versus pravastatin (20 mg twice daily) in patients with previous statin intolerance. Am J Cardiol. 2010;105:198–204.
19. Becker DJ, Gordon RY, Halbert SC, French B, Morris PB, Rader DJ. Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial. Ann Intern Med. 2009;150(12):830–9.
20. Becker DJ, French B, Morris PB, Silvent E, Gordon RY. Phytosterols, red yeast rice, and lifestyle changes instead of statins: a randomized, double-blinded, placebo-controlled trial. Am Heart J. 2013;166(1):187–96. This study evaluated the lipid lowering effects of phytosterol tablets and lifestyle modification in addition to red yeast rice in patients with statin intolerance. All 187 patients took red yeast rice and were randomized to phytosterol tablets or placebo for 52 weeks. Phytosterols did not significantly improve LDL-C compared with placebo. Patients were also randomized to lifestyle modification or usual care. The lifestyle modification group lost significantly more weight compared to the usual care group and had greater reductions in LDL-C.
21. Goldberg AC, Ostlund RE, Bateman JH, Schimmoeller L, McPherson TB, Spilburg CA. Effect of plant stanol tablets on low-density lipoprotein cholesterol lowering in patients on statin drugs. Am J Cardiol. 2006;97(3):376–9.
22. Venero CV, Venero JV, Wortham DC, Thompson PD. Lipid-lowering efficacy of red yeast rice in a population intolerant to statins. Am J Cardiol. 2010;105:664–6.
23. Sacks FM, Pfeffer MA, Moye LA, Rouleau JL, Rutherford JD, Cole TG, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med. 1996;335:1001–9.
24. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering on 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383–9.
25. The LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998;339:1349–57.
26. Yang CW, Mousa SA. The effect of red yeast rice (Monasucs purpureus) in dyslipidemia and other disorders. Complement Ther Med. 2012;20(6):466–74.
27. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov. Accessed December 5, 2014.
28. Gordon RY, Cooperman T, Obermeyer W, Becker DJ. Marked variability of monacolin levels in commercial red yeast rice products: buyer beware! Arch Intern Med. 2010;170:1722–7.
29. Klimek M, Wang S, Ogunkanmi A. Safety and efficacy of red yeast rice (Monascus purpureus) as an alternative therapy for hyperlipidemia. P&T A PeerRev J Formul Manag. 2009;34(6):313–27.