TY - JOUR
T1 - Effects of morning vs evening statin administration on lipid profile
T2 - A systematic review and meta-analysis
AU - Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group
AU - Awad, Kamal
AU - Serban, Maria Corina
AU - Penson, Peter
AU - Mikhailidis, Dimitri P.
AU - Toth, Peter P.
AU - Jones, Steven R.
AU - Rizzo, Manfredi
AU - Howard, George
AU - Lip, Gregory Y.H.
AU - Banach, Maciej
N1 - Publisher Copyright:
© 2017 National Lipid Association
PY - 2017/7
Y1 - 2017/7
N2 - Background Evidence about the optimal time of day at which to administer statins is lacking. Objective The objective of this study is to synthesize evidence about effects of morning vs evening statin administration on lipid profile. Methods We searched PubMed, SCOPUS, Web of Science, and Embase databases (from inception up to July 24, 2016) to identify the relevant studies. Mean differences (MDs) between the change scores in lipid parameters were pooled using a fixed-effect model. Results Eleven articles with 1034 participants were eligible for the analysis. The pooled analysis comparing effects of morning vs evening administration of statins on plasma total cholesterol (TC; P =.10), high-density lipoprotein cholesterol (P =.90), and triglycerides (P =.45) was not statistically significant. Low-density lipoprotein cholesterol (LDL-C) lowering was statistically greater in the evening-dose group (MD: 3.24 mg/dL, 95% CI: 1.23–5.25, P =.002). Subgroup analysis according to statin half-lives showed that evening dose of statins was significantly superior to morning dose for lowering LDL-C in case of both short and long half-life statins (MD: 9.68 mg/dL, 95% CI: 3.32–16.03, P =.003 and MD: 2.53 mg/dL, 95% CI: 0.41–4.64, P =.02, respectively) and also for TC reduction in case of short half-life statins only (P =.0005). Conclusions LDL-C and TC lowering was significantly greater in the evening dose than in the morning dose in case of short-acting statins. Besides slight but significant effect on LDL-C, the efficacy of long-acting statins was equivalent for both regimens. Therefore, long-acting statins should be given at a time that will best aid compliance. Short-acting statins should be given in the evening.
AB - Background Evidence about the optimal time of day at which to administer statins is lacking. Objective The objective of this study is to synthesize evidence about effects of morning vs evening statin administration on lipid profile. Methods We searched PubMed, SCOPUS, Web of Science, and Embase databases (from inception up to July 24, 2016) to identify the relevant studies. Mean differences (MDs) between the change scores in lipid parameters were pooled using a fixed-effect model. Results Eleven articles with 1034 participants were eligible for the analysis. The pooled analysis comparing effects of morning vs evening administration of statins on plasma total cholesterol (TC; P =.10), high-density lipoprotein cholesterol (P =.90), and triglycerides (P =.45) was not statistically significant. Low-density lipoprotein cholesterol (LDL-C) lowering was statistically greater in the evening-dose group (MD: 3.24 mg/dL, 95% CI: 1.23–5.25, P =.002). Subgroup analysis according to statin half-lives showed that evening dose of statins was significantly superior to morning dose for lowering LDL-C in case of both short and long half-life statins (MD: 9.68 mg/dL, 95% CI: 3.32–16.03, P =.003 and MD: 2.53 mg/dL, 95% CI: 0.41–4.64, P =.02, respectively) and also for TC reduction in case of short half-life statins only (P =.0005). Conclusions LDL-C and TC lowering was significantly greater in the evening dose than in the morning dose in case of short-acting statins. Besides slight but significant effect on LDL-C, the efficacy of long-acting statins was equivalent for both regimens. Therefore, long-acting statins should be given at a time that will best aid compliance. Short-acting statins should be given in the evening.
KW - Cholesterol
KW - Half-life
KW - Hydroxymethylglutaryl-CoA reductase inhibitors
KW - LDL
KW - Lipids
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U2 - 10.1016/j.jacl.2017.06.001
DO - 10.1016/j.jacl.2017.06.001
M3 - Article
C2 - 28826569
AN - SCOPUS:85028359187
SN - 1933-2874
VL - 11
SP - 972-985.e9
JO - Journal of clinical lipidology
JF - Journal of clinical lipidology
IS - 4
ER -