Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 36805484 · doi:10.1016/j.phymed.2023.154716
What was done
A systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the efficacy and safety of berberine in cardiovascular diseases across ten electronic databases from inception to December 23, 2022. The review included RCTs comparing berberine alone or combined with statins versus statins or routine care according to Cochrane Handbook methods.
What was found
Forty-four RCTs with 4,606 patients were analyzed. Berberine monotherapy showed no significant differences versus routine or statin therapy for total cholesterol (SMD, 0.43; 95% CI, -0.39 to 1.24; p = 0.30; I² = 95%), triglycerides (SMD, -0.14; 95% CI, -0.49 to 0.21; p = 0.44; I² = 76%), LDL-C (SMD, 0.69; 95% CI, -0.23 to 1.60; p = 0.14; I² = 96%), HDL-C (SMD, 0.55; 95% CI, -0.48 to 1.57; p = 0.30; I² = 96%), or Crouse score, but significantly reduced NIHSS score, hs-CRP, IL-6, TNF-α, and intima-media thickness (IMT). Berberine plus statins significantly reduced total cholesterol, triglycerides, LDL-C, NIHSS score, hs-CRP, TNF-α, IMT, Crouse score, and number of unstable plaques compared to routine or statins alone, with no difference in HDL-C or IL-6. No significant differences in adverse reactions were found between groups.
Why it matters
Berberine combined with statins may offer therapeutic benefit for lipid management, inflammation reduction, and plaque stability in cardiovascular disease without increasing adverse events.
Limits
Statistical heterogeneity among lipid analyses was extremely high (I² from 76% to 96%). The review's findings are limited by the quality of the included original RCTs, and exact effect estimates for non-lipid outcomes were not reported in the abstract.
Cited by
- supports Berberine co-administration lowers the side effects of statin-induced myopathy and reduces the required effective statin dose to lower LDL cholesterol.