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Safety of Red Yeast Rice for High Cholesterol in Individuals With Statin Intolerance

This study has been completed.
Chestnut Hill Health System
Information provided by:
University of Pennsylvania Identifier:
First received: March 14, 2008
Last updated: December 9, 2009
Last verified: December 2009
This study will examine the effect of red yeast rice extract compared to pravastatin on muscle related complaints in individuals with high cholesterol who have previously been unable to tolerate statin medications due to muscle pain. The study will determine whether red yeast is associated with a lower level of muscle related complaints compared to pravastatin.

Condition Intervention Phase
Hypercholesterolemia Statin-Associated Myopathy Dietary Supplement: Red Yeast Rice Drug: Pravastatin Behavioral: Lifestyle modification program Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: Red Yeast Rice vs. Pravastatin: A Double-Blind Randomized Comparative Study of Myopathic Symptoms

Resource links provided by NLM:

Further study details as provided by University of Pennsylvania:

Primary Outcome Measures:
  • Withdrawal of Therapy Due to Muscle Symptoms That Are Either Intolerable and/or Associated With a Creatine Kinase(CK) >500 [ Time Frame: 12 weeks ]

Secondary Outcome Measures:
  • Change in LDL-Cholesterol Measured at the Beginning and End of the Study [ Time Frame: 12 weeks ]

Enrollment: 43
Study Start Date: January 2008
Study Completion Date: October 2008
Primary Completion Date: July 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Pravastatin Drug: Pravastatin
One 20mg capsule twice daily for 12 weeks
Other Name: Pravachol
Behavioral: Lifestyle modification program
Weekly sessions each lasting 3 1/2 hours for 12 weeks
Experimental: Red yeast Rice Dietary Supplement: Red Yeast Rice
Four 600mg capsules twice daily for 12 weeks
Behavioral: Lifestyle modification program
Weekly sessions each lasting 3 1/2 hours for 12 weeks

Detailed Description:

20 million Americans are actively treated with statins at an annual cost of 16 billion dollars. Statins are effective therapeutic agents for reducing LDL cholesterol and have documented effectiveness. However, a significant subset of patients (5-18%), cannot tolerate lipid lowering statin therapy due to intolerable muscle-related symptoms characterized by muscle pain and/or weakness. These symptoms affect quality of life and lead to poor adherence.

Patients may seek alternative therapies to manage hypercholesterolemia if they have been intolerant of statin therapy. One commonly used alternative treatment option is the Chinese herb red yeast rice extract. Several small studies performed in China, have suggested this treatment is efficacious and well tolerated. In the U.S. red yeast rice is sold over the counter a dietary supplement.

The objective of this study is to critically examine the safety and efficacy of the Chinese herb red yeast rice as an alternative lipid lowering therapy, in a statin intolerant population.

This objective will be operationalized by a double-blind randomized trial, comparing the effect of red yeast rice extract, to that of pravastatin on the level of myalgia in subjects with a prior history of statin-induced myalgias.

The specific aims include:

  1. Determine the relative rates of withdrawal from treatment in subjects receiving red yeast rice compared to pravastatin.
  2. Determine if red yeast rice is associated with a lower level of muscle pain (myalgia) symptoms compared to pravastatin as measured by the Brief Pain Inventory, a validated pain questionnaire.
  3. Determine if red yeast rice is associated with a lower level of muscle weakness compared to pravastatin as measured by a dynamometry, a validated muscle strength testing method.

Ages Eligible for Study:   21 Years to 80 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Subject reports stopping at least one statin drug due to complaints of muscle pain or weakness which his/her physician thinks was attributable to the drug.
  • Subject has never taken pravastatin.
  • Subject willing to remain off the dietary supplements CoQ10, L-carnitine, fish oil, policosanol, and guggulipid, garlic, and phytosterols in margarines (e.g. Benecol, Promise activ), milk or cereal products, for one month prior to the trial and for the duration of the trial.

Exclusion Criteria:

  • A history of muscle damage (CK>1000 IU) on statin therapy.
  • A history of generalized chronic pain such as fibromyalgia, or generalized arthritis.
  • Any active cardiac problem including chest pain, angina, heart attack, bypass surgery, angioplasty/stent or unstable angina/acute coronary syndrome within the past 6 months.
  • Taking other lipid lowering drugs including: ezetimibe, gemfibrozil, niacin, fibrates or bile acid sequestrants.
  • Triglyceride level more than 400 mg/dl.
  • Taking weight loss medication including orlistat, sibutramine, diethylpropion, phendimetrazine, phentermine.
  • Taking pain medication or systemic steroids on a chronic basis.
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Please refer to this study by its identifier: NCT00639223

United States, Pennsylvania
Chestnut Hill Hospital
Philadelphia, Pennsylvania, United States, 19118
Sponsors and Collaborators
University of Pennsylvania
Chestnut Hill Health System
Study Director: Steven C Halbert, MD University of Pennsylvania
  More Information

Responsible Party: David Becker MD Principal Investigator, Chestnut Hill Health System Identifier: NCT00639223     History of Changes
Other Study ID Numbers: 806827
Study First Received: March 14, 2008
Results First Received: December 9, 2009
Last Updated: December 9, 2009

Keywords provided by University of Pennsylvania:
Statin related myalgia
Red yeast rice
Cardiovascular Diseases
Nutritional and Metabolic Diseases

Additional relevant MeSH terms:
Lipid Metabolism Disorders
Metabolic Diseases
Red yeast rice
Anticholesteremic Agents
Hypolipidemic Agents
Molecular Mechanisms of Pharmacological Action
Lipid Regulating Agents
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Enzyme Inhibitors processed this record on September 21, 2017