Statin administration in the morning or in the evening

Statin administration in the evening may not improve cholesterol levels compared to administration in the morning, and there may not be differences in adverse events.

The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding), and by imprecise results (wide confidence intervals).

Summary

A Cochrane review included 8 studies with a total of 767 subjects with hyperlipidaemia. The studies compared morning versus evening administration of statins (lovastatin 2 studies, simvastatin 3 studies, fluvastatin 2 studies, pravastatin 1 study), and the study length ranged from 4 to 14 weeks. None of the included studies reported data on cardiovascular mortality, cardiovascular morbidity, incidence of cardiovascular events, or deaths from any cause. There was no difference in total cholesterol (MD 4.33, 95% CI -1.36 to 10.01; 5 studies, n=514), low-density lipoprotein cholesterol (LDL-C) levels (MD 4.85 mg/dL, 95% CI -0.87 to 10.57; 5 studies, n=473), high-density lipoprotein cholesterol (HDL-C) (MD 0.54, 95% CI -1.08 to 2.17; 5 studies, n=514) or triglycerides (MD -8.91, 95% CI -22 to 4.17; 5 studies, n=510) between morning and evening statin administration. With regard to safety outcomes, 5 studies (n=556) reported adverse events. There were no differences in statins adverse events between morning and evening intake (OR 0.71, 95% CI 0.44 to 1.15; 5 studies, n=556).

Clinical comments

Date of latest search:

Ədəbiyyat

1. Izquierdo-Palomares JM, Fernandez-Tabera JM, Plana MN et al. Chronotherapy versus conventional statins therapy for the treatment of hyperlipidaemia. Cochrane Database Syst Rev 2016;(11):CD009462.