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Effects of Morning Versus Evening Statin Administration on Lipid Profile: A Systematic Review and Meta-Analysis

Awad, K and Sahebkar, A and Penson, P and Mikhailidis, D and Toth, P and Jones, S and Rizzo, M and Howard, G and Lip, G and Banach, M (2017) Effects of Morning Versus Evening Statin Administration on Lipid Profile: A Systematic Review and Meta-Analysis. Journal of Clinical Lipidology. ISSN 1933-2874

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Abstract

Background: Evidence about the optimal time of day at which to administer statins is lacking.
Objective: To synthesize evidence about effects of morning versus evening statin administration on lipid profile.
Methods: We searched PubMed, SCOPUS, Web of Science and Embase databases (from inception up to July 24th, 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 versus evening administration of statins on plasma total cholesterol (TC) (p=0.10), high density lipoprotein cholesterol (HDL-C) (p=0.90) and triglycerides (TG) (p=0.45) 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=0.002). 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=0.003, and 2.53 mg/dl, 95%CI: 0.41, 4.64, p=0.02, respectively), and also for TC reduction in case of short half-life statins only (p=0.0005).
Conclusions: LDL-C and TC lowering were 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.

Item Type: Article
Uncontrolled Keywords: 1101 Medical Biochemistry And Metabolomics, 1102 Cardiovascular Medicine And Haematology
Subjects: R Medicine > RM Therapeutics. Pharmacology
Divisions: Pharmacy & Biomolecular Sciences
Publisher: Elsevier
Date Deposited: 14 Jun 2017 11:46
Last Modified: 07 Sep 2017 23:57
DOI or Identification number: 10.1016/j.jacl.2017.06.001
URI: http://researchonline.ljmu.ac.uk/id/eprint/6701

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