Efficacy and Safety of Berberine Alone or Combined with Statins for the Treatment of Hyperlipidemia: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 31094214 · doi:10.1142/S0192415X19500393
What was done
A systematic review and meta-analysis of six electronic databases (SinoMed, CNKI, WanFang Data, PubMed, Embase, Cochrane Library) through March 8, 2018, evaluated randomized controlled trials investigating berberine alone or combined with statins for the treatment of hyperlipidemia. Two reviewers independently screened literature, extracted data, and assessed risk of bias. Meta-analysis was performed using RevMan 5.3 software.
What was found
Eleven RCTs involving 1,386 patients were included. Compared with placebo, berberine significantly reduced total cholesterol and LDL and elevated HDL (P < 0.05). Compared with simvastatin monotherapy, berberine monotherapy was effective only in reducing triglycerides (MD = -0.37, 95% CI: -0.66 to -0.07, P = 0.02), with no statistically significant differences in LDL or HDL. Berberine plus simvastatin versus simvastatin alone showed greater reductions in triglycerides (MD = -0.33, 95% CI: -0.46 to -0.20, P < 0.00001) and total cholesterol (MD = -0.36, 95% CI: -0.60 to -0.12, P = 0.003). Berberine alone or with simvastatin showed lower rates of transaminase elevation and muscle aches than control groups, but higher incidence of constipation.
Why it matters
Berberine may serve as an adjunct or alternative lipid-lowering option, particularly for reducing triglycerides and total cholesterol, with a potentially lower rate of muscle and liver side effects compared to standard statin regimens.
Limits
The study authors explicitly note that the quality and quantity of the included RCTs were dissatisfactory, reducing the reliability of the conclusions. Specific dosages, treatment durations, and hard clinical cardiovascular outcomes were not reported in the abstract.
Cited by
- supports Berberine lowers LDL cholesterol across clinical scenarios comparing it to placebo or statins.
- supports Berberine co-administration lowers the side effects of statin-induced myopathy and reduces the required effective statin dose to lower LDL cholesterol.