Berberis aristata combined with Silybum marianum on lipid profile in patients not tolerating statins at high doses

- Adverse events are more common at higher doses of statins, and often contribute to patients low adherence to treatment.
- To reduce the risk of statin-induced adverse events, we can use a lower dose of statin combined with nonstatin drugs.
- Berberis aristata/Silybum marianum reduced fasting plasma glucose, insulin and HOMA-index compared to baseline and also to placebo.
- Lipid profile did not change with statin at half dose and B. aristata/S. marianum, while it worsened with placebo.
- B. aristata/S. marianum can be used in addition to statins in patients not tolerating high dose of these drugs.

AimTo evaluate the effects of Berberis aristata combined with Silybum marianum in dyslipidemic patients intolerant to statins at high doses.Methods137 euglycemic, dyslipidemic subjects, with previous adverse events to statins at high doses, were enrolled. Statins were stopped for 1 month (run-in), then they were re-introduced at the half of the previously taken dose. At randomization, patients tolerating the half dose of statin, were assigned to add placebo or B. aristata/S. marianum 588/105 mg, 1 tablet during the lunch and 1 tablet during the dinner, for six months. We evaluated lipid profile and safety parameters variation at randomization, and after 3, and 6 months.ResultsB. aristata/S. marianum reduced fasting plasma glucose (−9 mg/dl), insulin (−0.7 μU/ml), and HOMA-index (−0.35) levels compared to baseline and also to placebo. Lipid profile did not significantly change after 6 months since the reduction of statin dosage and the introduction of B. aristata/S. marianum, while it worsened in the placebo group both compared to placebo and with active treatment (+23.4 mg/dl for total cholesterol, +19.6 mg/dl for LDL-cholesterol, +23.1 mg/dl for triglycerides with placebo compared to B. aristata/S. marianum). We did not record any variations of safety parameters in nether of groups.ConclusionsB. aristata/S. marianum can be considered as addition to statins in patients not tolerating high dose of these drugs.