Red yeast rice for dyslipidaemias and cardiovascular risk reduction: A position paper of the International Lipid Expert Panel



Banach, Maciej, Catapano, Alberico L, Cicero, Arrigo FG, Escobar, Carlos, Foger, Bernhard, Katsiki, Niki, Latkovskis, Gustavs, Rakowski, Michal, Reiner, Zeljko, Sahebkar, Amirhossein
et al (show 2 more authors) (2022) Red yeast rice for dyslipidaemias and cardiovascular risk reduction: A position paper of the International Lipid Expert Panel. PHARMACOLOGICAL RESEARCH, 183. 106370-.

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Abstract

The risk of atherosclerotic cardiovascular disease (ASCVD) is strongly related to lifetime exposure to low-density lipoprotein (LDL)-cholesterol in longitudinal studies. Lipid-lowering therapy (using statins, ezetimibe and PCSK9 inhibitors) substantially ameliorates the risk and is associated with long-term reduction in cardiovascular (CV) events. The robust evidence supporting these therapies supports their continued (and expanding) role in risk reduction. In addition to these 'conventional' therapeutics, while waiting for other innovative therapies, growing evidence supports the use of a range of 'nutraceuticals' (constituents of food prepared as pharmaceutical formulations) including preparations of red yeast rice (RYR), the product of yeast (Monascus purpureus) grown on rice, which is a constituent of food and is used in traditional Chinese medicine. The major active ingredient, monacolin K, is chemically identical to lovastatin. RYR preparations have been demonstrated to be safe and effective in reducing LDL-C, and CV events. However, surprisingly, RYR has received relatively little attention in international guidelines - and conventional drugs with the strongest evidence for event reduction should always be preferred in clinical practice. Nevertheless, the absence of recommendations relating to RYR may preclude the use of a product which may have clinical utility in particular groups of patients (who may anyway self-prescribe this product), what in the consequence might help to reduce population CV risk. This Position Paper of the International Lipid Expert Panel (ILEP) will use the best available evidence to give advice on the use of red-yeast rice in clinical practice.

Item Type: Article
Uncontrolled Keywords: Monacolin, Red Yeast Rice, Cardiovascular risk, Risk stratification, No-statin therapy
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 26 Oct 2022 14:11
Last Modified: 18 Jan 2023 19:49
DOI: 10.1016/j.phrs.2022.106370
Open Access URL: https://doi.org/10.1016/j.phrs.2022.106370
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3165793