Effectiveness and safety of red yeast rice predominated by monacolin K β -hydroxy acid form for hyperlipidemia treatment and management

OBJECTIVE: To assess the lipid-lowering activity and safety of a dietary supplement containing monacolin K beta-hydroxy acid form (MKA), Heye (Folium Nelumbinis), and Cangzhu (Rhizoma Atractylodis Lanceae), compared to lifestyle modifications. METHODS: Totally 117 subjects with moderate to severe dyslipidemia (according to Chinese guidelines) and low CV risk were randomly assigned into three treatment groups: lifestyle modification (LM), LM plus a low dosage of MKA, LM plus a high dosage of MKA, and treated for 60 d. The primary endpoint was the reduction of low density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). Safeties along with Traditional Chinese Medicine Syndromes were assessed through the study. RESULTS: A low dosage of MKA along with lifestyle modifications caused a significant decrease in LDL-C by 15.6% on average (95% CI, 9.6% to 21%) with, a decrease in TC by 15.3% on average (95% CI , 9.26% to 21.4%), and a decrease in non-HDL-C by 35.4% (95% CI, 25.76% to 41.34%). Weak evidence of a reduction of triglycerides but an increment of HDL-C was observed in patients with severe hyperlipidemia. No severe adverse events occurred during the study. CONCLUSION: Our results confirm the LDL-C and TC lowering properties of MKA is clinically meaningful. It also produces a significant reduction of non-HDL-C, and slightly effects on TG and HDL-C as well. (c) 2022 JTCM. All rights reserved.