Red yeast rice preparations for dyslipidemia: An overview of systematic reviews and network meta-analysis

This research was to summarize the comparative efficacy and safety of red yeast rice (RYR) preparations and analyze the treatment ranking of lipid-lowering agents including RYR. Thirty-one systematic reviews (SRs) involving 165 randomized trials with 14,987 dyslipidemia participants were included. All the SRs showed a high overall risk of bias. A Bayesian network meta-analysis was performed. Only five trials reported major adverse cardiovascular events (MACE) and three trials reported lipoprotein(a)[Lp(a)]. Compared to placebo or other lipid-lowering drugs, RYR preparations showed some regulating action on lipids and glucose metabolism, with fewer side effects (P < 0.05). Compared to placebo, RYR showed a tendency to reduce Lp(a) levels. Lipid-lowering agents ranked differently in each outcome. High-quality evidence showed RYR (Zhibituo) lowered total cholesterol and triglyceride levels more than placebo. This study reveals the efficacy and safety ranking of RYR preparations for dyslipidemia, and it's recommended that future trials should focus on MACE and Lp(a).