Statins boosted by premeal psyllium fibre
Concomitant use of psyllium fibres, taken before meals, appears to enhance the cholesterol-lowering effects of statins, according to a recent meta-analysis.
The systematic review yielded three randomized controlled clinical studies eligible for inclusion. Two studies enrolled participants with high low-density lipoprotein cholesterol (LDL-C) levels at baseline, one of which assessed the efficacy of atorvastatin (study 1) while the other, simvastatin (study 2). The third study involved healthy individuals with normal baseline LDL-C.
In both studies with hypercholesterolaemic participants, psyllium supplementation improved the effects of statins. For instance, in study 2, a lower dose of simvastatin (10 mg), when given with 15.3 g/day of psyllium fibre, delivered a similar efficacy to that of the 20-mg dose. The same was true for study 3, which employed lovastatin.
The meta-analysis showed that study 1 (standard difference in means, –0.541; 95 percent CI, –0.959 to –0.134; p=0.009) and study 2 (standard difference in means, –0.661; –1.225 to –0.068; p=0.029) demonstrated the largest effects, with both studies showing a statistically significant advantage of psyllium supplementation to statin treatment alone.
This effect was absent in study 3 (standard differences in means, –0.229; –1.032 to 0.573; p=0.576), which was expected.
Pooling all three studies together showed that psyllium fibre supplementation significantly improved the efficacy of statins in reducing LDL-C levels (standard differences in means, –0.528; –0.837 to –0.218; p=0.001).