Date of Graduation

8-14-2010

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Dr. Mark Pedemonte, MD

Second Advisor

Annjanette Sommers MS, PAC

Third Advisor

Rob Rosenow PharmD, OD

Abstract

Background: Hyperlipidemia is a very common condition as it affects millions of people globally. With approximately 20% of the U.S. population having a total serum cholesterol levels above 240 mg/dL. Red yeast rice has been used as a natural alternative to statins, Red Yeast Rice (RYR) is a fermented biproduct of rice where the yeast, monascus purpureus, is grown. The components that makes RYR effective at lowering cholesterol are monacolin K.

Methods: A search of the literature published in the last twelve years was conducted using Medline, CINAHL, and ISI Web of Science. The terms researched were: Red Yeast Rice, monascus purpureus, LDL-C, LDL, hyperlipidemia, statin myalgias. A manual search was performed using references from the articles retrieved which yielded additional studies to be considered. Studies were eligible for inclusion only if they met all of the following criteria: statin intolerant adults with statin-induced myalgias resolved after discontinuation of statin drug. All other studies focusing on other products besides RYR were excluded.

Results: All three studies used for this systematic review demonstrated significant decreases in LDL-C in comparison to placebo and lifestyle modifications. Study 1 showed a decrease of 43 mg/dL from baseline LDL at week 12 and a drop of 35 mg/dL at week 24, compared to the placebo group whose LDL cholesterol decreased 11mg /dL at week 12, and by 15 mg/dL at week 24. Study 2: This 12 week study showed the mean LDL cholesterol concentration in RYR was 135 compared to 175 mg/dL in the placebo treated group, this was an overall reduction in 39 points from LDL in the placebo group compared to a 5 point drop in the placebo group. Study 3 : This 8 week study showed that LDL levels dropped significantly for the Went RYR group whole LDL decreased by 27.7% compared to placebo which dropped by 1.5 % after the 8 weeks.

Conclusion: Red Yeast Rice has been seen to reduce low density lipoprotein cholesterol by significant amounts in comparison to a placebo group. With patients requiring multiple lipid lowering medications, and many failing the generic and inexpensive lovastatin, it is necessary for studies to continue to prove the safety and efficacy of Red Yeast Rice as a replacement for statin drugs such as pravastatin, simvastatin, atorvastatin or fluvastatin.

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