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Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – A systematic review and meta-analysis
Open accessAbstract
Objective To verify the safety and effectiveness of traditional Chinese red yeast rice-extract (RYR) for reduction of LDL cholesterol.Methods Systematic literature review and meta-analysis. Medline and EMBASE were searched until November 2014. We selected randomized studies in which RYR with a known content of the active substance monacolin K was tested against placebo or an active control group. Outcome measures were the effect of RYR on LDL cholesterol and incidence of adverse reactions with emphasis on liver and kidney injury and muscle symptoms.Results Twenty studies were analyzed. Quality of safety assessment was low in the majority of studies. RYR lowered LDL cholesterol with 1.02 mmol/L [-1.20; -0.83] compared to placebo. Effect of RYR on LDL was not different from statin therapy (0.03 mmol/L [-0.36; 0.41]). The incidence of liver and kidney injury was 0-5% and the risk was not different between treatment and control groups (risk difference -0.01 [-0.01; 0.0] and 0.0 [-0.01; 0.02]).Conclusions RYR exerts a clinically and statistically significant reduction of 1.02 mmol/L LDL cholesterol. Only when the mild profile of adverse reactions can be affirmed in studies with adequate methodology for safety assessment, RYR might be a safe and effective treatment option for dyslipidemia and cardiovascular risk reduction in statin intolerant patients.
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“A meta-analysis of 20 RCTs evaluated the efficacy of RYR supplementation after 2–24 months that reduced LDL-C on average of 1.02 mmol/L (− 1.20; − 0.83) (39.4 mg/dL) compared to placebo which was not different from moderate-intensity statins (pravastatin 40 mg, simvastatin 10 mg, lovastatin 20 mg) (0.003 mmol/L; − 0.36; 0.41) (0.12 mg/dL).”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [36]
In the citing paper
“For all previously mentioned studies, there were no safety concerns (80,126-130).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [80]
In the citing paper
“RYR (1,200 to 4,800 mg/day) with a known content of the active substance monacolin K (4.8 and 24 mg) was tested against placebo or an active control group in 20 selected RCTs (80).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [80]
In the citing paper
“After 4 weeks, RYR reduced LDL-C by 1.02 mmol/l (39 mg/dl; p < 0.0001) compared with placebo, and the effect of RYR on LDL was not different from statin therapy (0.03 mmol/l [1.2 mg/dl]; p ¼ 0.89) in statin-”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [80]
In the citing paper
“The incidence of developing muscular symptoms was lower in RYR groups (0% to 23.8%) compared with control groups (0% to 36%).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [80]
In the citing paper
“There were no cases of rhabdomyolysis or myopathy with creatine kinase levels >10 times the upper limit of normal (80).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [80]
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Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.005 · Cited by 19,575
Cholesterol Treatment Trialists' (CTT) Collaboration (2010) · The Lancet · doi:10.1016/s0140-6736(10)61350-5 · Cited by 6,550
Sever, P., Dahlöf, B., Poulter, N. R., Wedel, H., Beevers, G., Caulfield, M. J., Collins, R., Kjeldsen, S. E., Kristinsson, A., McInnes, G. T., et al. (2003) · The Lancet · doi:10.1016/s0140-6736(03)12948-0 · Cited by 3,790
Stroes, E. S., Thompson, P. D., Corsini, A., Vladutiu, G. D., Raal, F. J., Ray, K. K., Roden, M., Stein, E., Tokgözoğlu, L., Nordestgaard, B. G., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv043 · Cited by 1,443
Bruckert, E., Hayem, G., Dejager, S., Yau, C., & Bégaud, B. (2005) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-005-5686-z · Cited by 1,226
Research works printed but not linked: 2
- Becker, 2009, A novel approach to lipid-lowering in patients with statin-associated myalgias: a randomized, placebo-controlled, double-blind trial, J. Am. Coll. Cardiol., 53, A209
- Roth, 2013, Red yeast rice extract shows equivalency to statins, Circulation, 128
Cited by
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Cicero, A. F. G., Colletti, A., Bajraktari, G., Descamps, O. S., Djuric, D. M., Владиславович, Е. М., Fras, Z., Katsiki, N., Langlois, M. R., Latkovskis, G., et al. (2017) · Nutrition Reviews · doi:10.1093/nutrit/nux047 · Cited by 303
Cicero, A. F. G., Colletti, A., Bajraktari, G., Descamps, O., Djuric, D. M., Ezhov, M., Fras, Z., Katsiki, N., Langlois, M., Latkovskis, G., et al. (2017) · Archives of Medical Science · doi:10.5114/aoms.2017.69326 · Cited by 281
“There were no cases of rhabdomyolysis or myopathy with CK levels increased more than 10 times the upper limit [89].”
BackgroundThe Role of Nutraceuticals in Statin Intolerant Patients
Banach, M., Patti, A. M., Giglio, R. V., Cicero, A. F. G., Atanasov, A. G., Bajraktari, G., Bruckert, E., Descamps, O., Djuric, D. M., Ezhov, M., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.04.040 · Cited by 272
Mancini, G. B. J., Baker, S. K., Bergeron, J., FITCHETT, D. H., Frohlich, J. J., Genest, J. J., Gupta, M., Hegele, R. A., Ng, D. S., Pearson, G. J., et al. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.01.003 · Cited by 257
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2017 Taiwan lipid guidelines for high risk patients
Li, Y., Ueng, K., Jeng, J., Charng, M., Lin, T., Chien, K., Wang, C., Chao, T., Liu, P., Su, C., et al. (2017) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2016.11.013 · Cited by 166
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Fogacci, F., Banach, M., Mikhailidis, D. P., Bruckert, É., Toth, P. P., Watts, G. F., Reiner, Ž., Mancini, J., Rizzo, M., Mitchenko, O., et al. (2019) · Pharmacological Research · doi:10.1016/j.phrs.2019.02.028 · Cited by 132
Ju, J., Li, J., Lin, Q., & Xu, H. (2018) · Phytomedicine · doi:10.1016/j.phymed.2018.09.212 · Cited by 124
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Xiong, Z., Cao, X., Wen, Q., Chen, Z., Cheng, Z., Huang, X., Zhang, Y., Long, C., Zhang, Y., & Huang, Z. (2019) · Food and Chemical Toxicology · doi:10.1016/j.fct.2019.110585 · Cited by 131
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BackgroundKirkpatrick, C. F., Sikand, G., Petersen, K. S., Anderson, C. A. M., Aspry, K. E., Bolick, J. P., Kris‐Etherton, P. M., & Maki, K. C. (2023) · Journal of clinical lipidology · doi:10.1016/j.jacl.2023.05.099 · Cited by 137
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Cicero, A. F. G., Fogacci, F., Stoian, A. P., Vrablik, M., Al Rasadi, K., Banach, M., Toth, P. P., & Rizzo, M. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00955-y · Cited by 110
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(ANS), E. P. O. F. A. A. N. S. A. T. F., Younes, M., Aggett, P. J., Aguilar, F., Crebelli, R., Dusemund, B., Filipič, M., Fernández, M. J. F., Galtier, P., Gott, D. M., et al. (2018) · EFSA Journal · doi:10.2903/j.efsa.2018.5368 · Cited by 110
Johnston, T. P., Короленко, Т. А., Pirro, M., & Sahebkar, A. (2017) · Pharmacological Research · doi:10.1016/j.phrs.2017.04.008 · Cited by 104
Pirro, M., Vetrani, C., Bianchi, C., Mannarino, M. R., Bernini, F., & Rivellese, A. A. (2017) · Nutrition, Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2016.11.122 · Cited by 99
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Functional food red yeast rice (RYR) for metabolic syndrome amelioration: a review on pros and cons
Patel, S. V. (2016) · World Journal of Microbiology and Biotechnology · doi:10.1007/s11274-016-2035-2 · Cited by 93
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Cicero, A. F. G., Fogacci, F., & Banach, M. (2019) · Methodist DeBakey Cardiovascular Journal · doi:10.14797/mdcj-15-3-192 · Cited by 99
Zong, C., Jiang, F., Wang, X., Li, P., Xu, L., & Yang, H. Q. (2021) · Biosensors and Bioelectronics · doi:10.1016/j.bios.2021.112998 · Cited by 85
Mazzanti, G., Moro, P. A., Raschi, E., Da Cas, R., & Menniti‐Ippolito, F. (2017) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.13171 · Cited by 81
“underestimation of adverse reactions [22].”
Nguyen, P. A. T., Karl, M., & Santini, A. (2017) · Foods · doi:10.3390/foods6030019 · Cited by 54
“Nonetheless, the clinical studies that showed the effectiveness of RYR in dyslipidemia also demonstrated that it is a relatively safe product [7,18].”
BackgroundBaumgartner, S., Bruckert, É., Gallo, A., & Plat, J. (2020) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2020.07.019 · Cited by 57
A network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults
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Pleiotropic effects of polyphenols on glucose and lipid metabolism: Focus on clinical trials
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Cicero, A. F. G., Fogacci, F., Stoian, A. P., & Toth, P. P. (2023) · Nutrients · doi:10.3390/nu15102288 · Cited by 47
“RYR provides lipid-lowering effects similar to those of low-dose, low-intensity statins [10,11] in subjects with mild-to-moderate hypercholesterolemia, with clinical-trial and real-world data demonstrating a favorable safety and tolerability profile similar to that of other statins [10,11,75,96].”
BackgroundBanach, M., Bruckert, É., Descamps, O. S., Ellegård, L., Владиславович, Е. М., Föger, B., Fras, Z., Kovanen, P. T., Latkovskis, G., März, W., et al. (2019) · Atherosclerosis Supplements · doi:10.1016/j.atherosclerosissup.2019.08.023 · Cited by 46
Cicero, A. F. G., Morbini, M., Rosticci, M., D’Addato, S., Grandi, E., & Borghi, C. (2016) · Annals of Nutrition and Metabolism · doi:10.1159/000445359 · Cited by 45
Variability in strength of red yeast rice supplements purchased from mainstream retailers
Cohen, P. A., Avula, B., & Khan, I. A. (2017) · European Journal of Preventive Cardiology · doi:10.1177/2047487317715714 · Cited by 43
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Nutritional and Additive Uses of Chitin and Chitosan in the Food Industry
Harkin, C., Mehlmer, N., Woortman, D. V., Brück, T. B., & Brück, W. M. (2019) · Sustainable Agriculture Reviews · doi:10.1007/978-3-030-16581-9_1 · Cited by 26
Impact of Red Yeast Rice on Metabolic Diseases: A Review of Possible Mechanisms of Action
Ju, H., Wang, J., Gan, Q., Ran, Q., Lou, G., Xiong, H., Peng, C., Sun, J.-L., Yao, R., & Huang, Q. (2020) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.0c01893 · Cited by 39
Mannino, G., Iovino, P., Lauria, A., Genova, T., Asteggiano, A., Notarbartolo, M., Porcu, A., Serio, G., Chinigò, G., Occhipinti, A., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22052664 · Cited by 40
“In particular, equally to other statins, monacolin K displayed anaphylaxis, hepatotoxicity, central nervous system complaints, rhabdomyolysis effects, and a high possibility of developing diabetes mellitus [7,14,19].”
BackgroundA Randomized Clinical Efficacy Trial of Red Yeast Rice (Monascus pilosus) Against Hyperlipidemia
Wang, T.-J., Lien, A. S., Chen, J.-L., Lin, C.-H., Yang, Y.-S., & Yang, S. (2019) · The American Journal of Chinese Medicine · doi:10.1142/s0192415x19500150 · Cited by 37
Marazzi, G., Campolongo, G., Pelliccia, F., Quattrino, S., Vitale, C., Cacciotti, L., Massaro, R., Volterrani, M., & Rosano, G. (2017) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2017.06.015 · Cited by 36
Higa, Y., Kim, Y., Altaf‐Ul‐Amin, M., Huang, M., Ono, N., & Kanaya, S. (2020) · BMC Genomics · doi:10.1186/s12864-020-06864-9 · Cited by 35
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Li, P., Wang, Q., Chen, K., Zou, S., Shu, S., Lu, C., Wang, S., Jiang, Y., Fan, C.-X., & Luo, Y. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.819482 · Cited by 38
2022 Taiwan lipid guidelines for primary prevention
Huang, P., Lu, Y., Tsai, Y., Wu, Y., Li, H., Chang, H.-Y., Wu, C., Yang, C., Tarng, D., Huang, C., et al. (2022) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2022.05.010 · Cited by 37
Ueng, K., Chiang, C., Chao, T., Wu, Y., Lee, W.-L., Li, Y., Ting, K.-H., Su, C.-H., Lin, H., Su, T., et al. (2023) · PubMed Central · doi:10.6515/acs.202301_39(1).20221103a · Cited by 34
Cicero, A. F. G., Morbini, M., Parini, A., Urso, R., Rosticci, M., Grandi, E., & Borghi, C. (2016) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s91817 · Cited by 33
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ResultRaschi, E., Girardi, A. M., Poluzzi, E., Forcesi, E., Menniti‐Ippolito, F., Mazzanti, G., & Ponti, F. D. (2018) · Drug Safety · doi:10.1007/s40264-018-0661-3 · Cited by 33
Yongxia, Z., Jian, X., Suyuan, H., Aixin, N., & Lihong, Z. (2020) · Journal de Mycologie Médicale · doi:10.1016/j.mycmed.2020.101038 · Cited by 33
Chiu, H., Shen, Y., Venkatakrishnan, K., & Wang, C. (2018) · Journal of Food Bioactives · doi:10.31665/jfb.2018.2137 · Cited by 30
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Guerrero-Bonmatty, R., Fernández, G. G., Rodríguez-Velasco, F. J., & Espadaler, J. (2021) · Nutrients · doi:10.3390/nu13041206 · Cited by 30
“Monacolin K is structurally equivalent to lovastatin [34], and its efficacy in reducing LDL-C has been studied in many clinical trials, with clear effects seen in metaanalyses [35,36].”
Backgroundde Castro-Orós, I., Solà, R., Valls, R. M., Brea, Á., Mozas, P., Puzo, J., & Pocovı́, M. (2016) · PLoS ONE · doi:10.1371/journal.pone.0150785 · Cited by 30
“have a cholesterol-lowering effect [25].”
Sivashanmugarajah, A. S., Fulcher, J., SULLIVAN, D. R., Elam, M. B., Jenkins, A. J., & KEECH, A. C. (2019) · Internal Medicine Journal · doi:10.1111/imj.14429 · Cited by 26
Cicero, A. F. G., D’Addato, S., & Borghi, C. (2020) · Nutrients · doi:10.3390/nu12103127 · Cited by 25
“4 mg/dL compared to placebo, which was comparable to the reduction achieved with regular-dosed statins (pravastatin 40 mg, simvastatin 10 mg, lovastatin 20 mg) [15].”
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Twarużek, M., Ałtyn, I., & Kosicki, R. (2021) · Toxins · doi:10.3390/toxins13070497 · Cited by 24
“It has also been shown that in combination with antioxidants, RYR reduces high sensitivity to C-reactive protein (hs-CRP) and endothelial dysfunction [29], as well as effectiveness in dyslipidemia [30,31].”
BackgroundPeng, D., Fong, A., & van Pelt, A. (2017) · AJN American Journal of Nursing · doi:10.1097/01.naj.0000521973.38717.2e · Cited by 24
“2014 Zeta Colest supplement (RYR, Silybum marianum, octasonol) Gerards MC, et al.(34) 2015 Meta-analysis of 20 studies; all tested RYR with known content of monacolin K in dosages ranging from 1,200 to 4,800 mg/day; some used multi-ingredient supplements Hobbs T, et al.”
MethodCicero, A. F. G., Morbini, M., Bove, M., D’Addato, S., Fogacci, F., Rosticci, M., & Borghi, C. (2016) · Current Medical Research and Opinion · doi:10.1080/03007995.2016.1190326 · Cited by 23
Fang, Y., Song, H., Liang, J., Li, P., & Yang, H. Q. (2017) · Analytical Methods · doi:10.1039/c7ay00777a · Cited by 24
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Sungthong, B., Yoothaekool, C., Promphamorn, S., & Phimarn, W. (2020) · Scientific Reports · doi:10.1038/s41598-020-59796-5 · Cited by 22
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Venhuis, B. J., van Hunsel, F. P. A. M., van de Koppel, S., Keizers, P. H. J., Jeurissen, S. M. F., & de Kaste, D. (2016) · Drug Testing and Analysis · doi:10.1002/dta.1929 · Cited by 21
Hachem, R., Assemat, G., Balayssac, S., Martins-Froment, N., Gilard, V., Martino, R., & Malet‐Martino, M. (2020) · Molecules · doi:10.3390/molecules25020317 · Cited by 21
“However, several clinical trials using RYR products at daily MK doses well below 10 mg (around 5 mg and even 3 mg) without any other cholesterol-lowering agents such as berberine, policosanol or garlic, showed a statistically significant reduction in LDL-C compared to placebo but these low values either corresponded t…”
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“The prevalent use of RYR medications is still specific, and they should not be included in place of statins or other LDL-c lowering pharmacological approaches as the mainstay potential therapy for efficiently lowering CVD risk, especially in patients with high or very high CVD risk, as current guidelines highly sugges…”
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“In previous RCTs, the rates of kidney injury, liver enzyme elevation, and muscle-related symptoms were reported as similar between the red yeast rice and placebo groups (26, 51).”
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Food supplements with red yeast rice: more regulations are needed
De Backer, G. G. (2017) · European Journal of Preventive Cardiology · doi:10.1177/2047487317716500 · Cited by 17
“In randomized placebo-controlled trials it has been shown that RYR reduces triglycerides and total- and LDL-cholesterol.(1,2) Like statins monacolin K is an inhibitor of the HMG-CoA reductase enzyme that is involved in the synthesis of cholesterol.”
BackgroundAssimilation of Cholesterol by Monascus purpureus
Nguyen, T. P. T., Garrahan, M. A., Nance, S. A., Seeger, C. E., & Wong, C. (2020) · Journal of Fungi · doi:10.3390/jof6040352 · Cited by 19
Trogkanis, E., Karalexi, M. A., Sergentanis, T. Ν., Kornarou, E., & Vassilakou, T. (2024) · Nutrients · doi:10.3390/nu16101453 · Cited by 16
“Congruently with the present study, previous systematic reviews and meta-analyses have also reported positive effects of RYR extract consumption [35,36], enhancing the evidence that the use of RYR extract seems to significantly reduce both total cholesterol and LDL-C to a similar extent.”
ResultInfluentialRed yeast rice: a functional food used to reduce hyperlipidemia
Fan, X., Han, J., Zhang, F., & Chen, W. (2022) · Food Reviews International · doi:10.1080/87559129.2022.2043894 · Cited by 14
Chan, M., Larsen, N., Baxter, H., Jespersen, L., Ekinci, E. I., & Howell, K. S. (2023) · Nutrition Research Reviews · doi:10.1017/s0954422423000252 · Cited by 15
Clinoptilolite for Treatment of Dyslipidemia: Preliminary Efficacy Study
Cutovic, M. R., Lazovic, M. P., Vuković-Dejanović, V., Nikolić, D., Petronić, I., & Ćirović, D. (2017) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2016.0414 · Cited by 15
“21,22 Berberine, another Chinese herbal compound, may also decrease LDLc (25%), TC (30%), and TG (35”
An overview on the therapeutic potential and anticancer mechanism of Monacolin K / Lovastatin
Monu, M., Sehrawat, K. D., Singh, A. P., Chaudhary, G., Bamal, D., & Sehrawat, A. R. (2022) · Pharmacological Research - Modern Chinese Medicine · doi:10.1016/j.prmcm.2022.100187 · Cited by 14
Effects of red yeast rice prescription (LipoCol Forte) on adverse outcomes of surgery
Chen, T. L., Yeh, C. C., Lin, C. S., Shih, C. C., & Liao, C. C. (2018) · QJM · doi:10.1093/qjmed/hcy278 · Cited by 14
Yang, C. Y., Wu, Y., Qian, J., & Li, J. (2024) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2024.05.011 · Cited by 13
“…(cid:1) 1.20 to (cid:1) 0.83), triglycerides by (cid:1) 0.26 mmol/L ( (cid:1) 0.35 to (cid:1) 0.17), total cholesterol (TC) by (cid:1) 1.0 mmol/L ( (cid:1) 1.23 to (cid:1) 0.77), and high-density lipoprotein cholesterol (HDL-C) by 0.07 mmol/L (0.03 e 0.11) after 6 e 168 weeks of follow-up 14,15 .”
InfluentialBanach, M., & Norata, G. D. (2023) · Current Atherosclerosis Reports · doi:10.1007/s11883-023-01157-4 · Cited by 12
“In a meta-analysis of 20 studies involving 6663 subjects, no single rhabdomy-olysis event was reported in subjects taking RYR preparations containing 4.8 to 24 mg monacolin K per day [24].”
BackgroundInfluentialNatural Products for the Treatment of Non-Alcoholic Fatty Liver Disease: A Comprehensive Review
Nucera, S., Bulotta, R. M., Ruga, S., Caminiti, R., Serra, M. D. R., Bava, R., Castagna, F., Lupia, C., Marrelli, M., Conforti, F., et al. (2023) · Scientia Pharmaceutica · doi:10.3390/scipharm91040053 · Cited by 12
Posadzki, P., AlBedah, A. M. N., Khalil, M., & Alqaed, M. S. (2016) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2016.09.019 · Cited by 12
Vrolijk, M. F., van de Koppel, S., & van Hunsel, F. P. A. M. (2020) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.14599 · Cited by 12
Grujić-Milanović, J. D., Rajković, J., Milanović, S., Jacevic, V. M., Miloradović, Z., Nežić, L., & Novaković, R. (2023) · Antioxidants · doi:10.3390/antiox12122088 · Cited by 11
“A meta-analysis of 6663 patients (from 20 randomized clinical trials) treated with red yeast rice extract showed a reduction in low-density cholesterol (LDL) [44].”
BackgroundInfluentialNorata, G. D., & Banach, M. (2024) · Nutrients · doi:10.3390/nu16030444 · Cited by 11
Russo, V., Napolitano, N., Ascrizzi, A., Leonardi, S., Pisacane, F., Micco, P. D., Imbalzano, E., Sasso, F. C., D’Andrea, A., Caturano, A., et al. (2024) · Pharmaceuticals · doi:10.3390/ph17040447 · Cited by 11
“A meta-analysis of 20 randomized controlled trials found that supplementation with RYR for 2–24 months led to an average reduction of 1.02 mmol/L in LDL cholesterol compared to placebo [29]; moreover, RYR increased HDL-C and reduced triglycerides when compared to placebo [29].”
BackgroundInfluentialThe Use of Medications and Dietary Supplements by Masters Athletes — a Review
Harnett, J., Climstein, M., Walsh, J., & Gifford, J. A. (2022) · Current Nutrition Reports · doi:10.1007/s13668-022-00398-0 · Cited by 12
Liu, X., Zeng, X., Mahe, J., Guo, K., He, P., Yang, Q., Zhang, Z., Li, Z., Wang, D., Zhang, Z., et al. (2023) · Nutrients · doi:10.3390/nu15194239 · Cited by 11
Tangni, E. K., Hove, F. V., Huybrechts, B., Masquelier, J., Vandermeiren, K., & Hoeck, E. V. (2021) · Toxins · doi:10.3390/toxins13040245 · Cited by 11
“In addition, the use of red yeast rice (RYR) in dietary food supplements has gained popularity in Europe due to its ability to achieve and maintain healthy cholesterol levels [5].”
BackgroundProtic, O., Bonfigli, A. R., & Antonicelli, R. (2021) · Nutrients · doi:10.3390/nu13093128 · Cited by 11
“These results were similar to the effects of 40 mg of pravastatin, 20 mg of lovastatin, and 10 mg of simvastatin [6,27].”
ResultEFSA Panel on Nutrition, N. F. A. F. A. (., Turck, D., Bohn, T., Cámara, M., Castenmiller, J. J. M., Henauw, S. D., Hirsch‐Ernst, K. I., Jos, A. M., Mangelsdorf, I., McNulty, B. A., et al. (2025) · EFSA Journal · doi:10.2903/j.efsa.2025.9276 · Cited by 10
“The narrative review by Banach et al. (2024) summarised the findings of meta-analyses of RCTs designed to test the efficacy of RYR on the blood lipid profile and also reported on adverse effects (Fogacci et al., 2019; Gerards et al., 2015; Li et al., 2014; Peng et al., 2017).”
Nutraceutical Approaches to Dyslipidaemia: The Main Formulative Issues Preventing Efficacy
Colletti, A., Fratter, A., Pellizzato, M., & Cravotto, G. (2022) · Nutrients · doi:10.3390/nu14224769 · Cited by 10
Enhancing the Operational Semantics of the Entity-Relationship Model.
Parent, C. E., & Spaccapietra, S. (1985) · Discovery Science · Cited by 10
Hermans, M. P., Dierckxsens, Y., Janssens, I., Seidel, L., Albert, A., Ahn, S. A., Rousseau, M. F., & Khan, A. P. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1280234 · Cited by 11
von Känel-Cordoba, I., Wirnitzer, K., Weiss, K., Nikolaidis, P. Τ., Devrim-Lanpir, A., Hill, L., Rosemann, T. J., & Knechtle, B. (2024) · Journal of Health Population and Nutrition · doi:10.1186/s41043-024-00679-0 · Cited by 9
Angelopoulos, N., Paparodis, R. D., Androulakis, I. P., Boniakos, A., Argyrakopoulou, G., & Livadas, S. (2023) · Nutrients · doi:10.3390/nu15122682 · Cited by 9
Supplements for Lipid Lowering: What Does the Evidence Show?
Mirzai, S., & Laffin, L. J. (2023) · Current Cardiology Reports · doi:10.1007/s11886-023-01903-9 · Cited by 9
Liasi, E., Kantilafti, M., Hadjimbei, E., & Chrysostomou, S. (2024) · Medicina de Familia SEMERGEN · doi:10.1016/j.semerg.2023.102156 · Cited by 8
Cicero, A. F. G., Fogacci, F., Tocci, G., D’Addato, S., Grandi, E., Banach, M., & Borghi, C. (2023) · Archives of Medical Science · doi:10.5114/aoms/167969 · Cited by 9
“The dose-dependent lipid-lowering efficacy of RYR has been confirmed by large meta-analyses of randomized controlled clinical trials (RCTs); however, its safety is also inversely related to the daily dose employed [12, 13].”
BackgroundRed Yeast Rice (RYR) supplementation in patients treated with second-generation antipsychotics
Bruno, A., Pandolfo, G., Crucitti, M., Troili, G. M., Spina, E., Zoccali, R. A., & Muscatello, M. R. A. (2018) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2018.03.007 · Cited by 8
Development of new food products based on phytonutrients
Bule, M. H., Issa, I. A., Khan, F., Shah, M. A., & Niaz, K. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815354-3.00008-3 · Cited by 8
Effects of Nutritional Supplements on Human Health
Cádiz‐Gurrea, M. D. L. L., Soares, S., Leyva‐Jiménez, F. J., Fernández‐Ochoa, Á., Pinto, D., Delerue-Matos, C. M., Segura‐Carretero, A., & Rodrigues, F. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-816450-1.00004-0 · Cited by 8
Metadata
- Authors
- Gerards, M. C., Terlou, R. J., Yu, H., Koks, C. H. W., & Gerdes, V. E. A.
- Affiliations
- Slotervaartziekenhuis (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- The Netherlands Cancer Institute (NL)
- Corresponding author
- Gerards, Maaike C.
- Venue
- Atherosclerosis
- Publisher
- Elsevier BV
- Published
- 2015-06
- Volume
- 240
- Issue
- 2
- Pages
- 415-423
- ISSN
- 0021-9150 (ISSN-L)
- OpenAlex
- W1973557710
- Cited by
- 169
- References
- 65
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 18 · 2023: 17 · 2022: 15 · 2021: 23 · 2020: 19 · 2019: 13 · 2018: 14 · 2017: 15 · 2016: 14 · 2015: 3
- FWCI
- 2.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Atherosclerosis (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Natural Products and Biological Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
- Keywords
- red yeast rice, lovastatin, LDL cholesterol lowering, lipid-lowering drugs, drug safety, adverse drug reactions, liver injury, kidney injury, muscle symptoms, statin intolerance, dyslipidemia, cardiovascular risk reduction
- MeSH terms
- Anticholesteremic Agents, Biological Products, Humans, Hypercholesterolemia, Cholesterol, LDL, Lovastatin, Medicine, Chinese Traditional, Risk Factors, Biomarkers, Chi-Square Distribution, Odds Ratio, Treatment Outcome, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Dietary Supplements
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