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Efficacy and safety of berberine for dyslipidaemias: A systematic review and meta-analysis of randomized clinical trials.
Phytomedicine 2018; 50:25-34P

Abstract

BACKGROUND

In recent years, berberine has become widely used as an effective alternative to treat dyslipidaemias; much clinical evidence has emerged. It is important to systematically and critically evaluate the existing evidence.

PURPOSE

This study aims to evaluate the efficacy and safety of berberine in patients with dyslipidaemias.

STUDY DESIGN

A systematic review and meta-analysis of randomized clinical trials.

METHODS

Five electronic databases were searched up to Apr 15, 2018 to identify randomized controlled trials (RCTs) of berberine in treatment of dyslipidaemias. The outcomes were lipid profile parameters and adverse events. Study selection, data collection, risk of bias assessment, data analyses and interpretations were conducted according to the Cochrane handbook.

RESULTS

Sixteen trials with total of 2147 participants were judged to be eligible and were included in the meta-analysis. The included trials were assessed to be of high clinical heterogeneity. The methodological quality of the majority of the trials was generally low in terms of random sequence generation, allocation concealment, blinding and incomplete outcome data. Thus, selection bias, performance bias, detection bias, attrition bias and confounding bias might exist. Meta-analysis showed that berberine significantly reduced levels of total cholesterol (TC) (MD = -0.47 mmol/l 95% CI [-0.64, -0.31], p < 0.00001), low-density lipoprotein cholesterol (LDL-C) (MD =-0.38 mmol/l 95% CI [-0.53, -0.22], p < 0.00001) and triglycerides (TG) (MD = -0.28 mmol/l 95% CI [-0.46, -0.10], p = 0.002). Berberine also increased the level of high-density lipoprotein cholesterol (HDL-C) when used alone (MD = 0.08 mmol/l 95% CI [0.03, 0.12], p = 0.001). No significant differences were found between groups in terms of incidence of adverse events (RR = 0.64 95% CI [0.31, 1.30], p = 0.22). No severe adverse effects were reported in either group.

CONCLUSION

Berberine improves lipid profiles in dyslipidaemias with satisfactory safety. Nevertheless, these findings should be interpreted with caution because of the high clinical heterogeneity and high risk of bias in the included trials. Rigorous clinical trials should be carried out to provide more reliable evidence.

Authors+Show Affiliations

Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China.Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.Graduate School, China Academy of Chinese Medical Sciences, Beijing 100700, China.Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.. Electronic address: xuhaotcm@hotmail.com.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

30466986

Citation

Ju, Jianqing, et al. "Efficacy and Safety of Berberine for Dyslipidaemias: a Systematic Review and Meta-analysis of Randomized Clinical Trials." Phytomedicine : International Journal of Phytotherapy and Phytopharmacology, vol. 50, 2018, pp. 25-34.
Ju J, Li J, Lin Q, et al. Efficacy and safety of berberine for dyslipidaemias: A systematic review and meta-analysis of randomized clinical trials. Phytomedicine. 2018;50:25-34.
Ju, J., Li, J., Lin, Q., & Xu, H. (2018). Efficacy and safety of berberine for dyslipidaemias: A systematic review and meta-analysis of randomized clinical trials. Phytomedicine : International Journal of Phytotherapy and Phytopharmacology, 50, pp. 25-34. doi:10.1016/j.phymed.2018.09.212.
Ju J, et al. Efficacy and Safety of Berberine for Dyslipidaemias: a Systematic Review and Meta-analysis of Randomized Clinical Trials. Phytomedicine. 2018 Nov 15;50:25-34. PubMed PMID: 30466986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of berberine for dyslipidaemias: A systematic review and meta-analysis of randomized clinical trials. AU - Ju,Jianqing, AU - Li,Jingen, AU - Lin,Qian, AU - Xu,Hao, Y1 - 2018/09/28/ PY - 2018/06/28/received PY - 2018/09/24/revised PY - 2018/09/25/accepted PY - 2018/11/24/entrez PY - 2018/11/24/pubmed PY - 2019/1/19/medline KW - Berberine KW - CAD KW - CAS KW - Dyslipidaemias KW - HDL-C KW - IGT KW - ITT KW - LDL-C KW - LLDs KW - Lipid profile KW - Meta-analysis KW - RCTs KW - Randomized controlled trial KW - Systematic review KW - T2DM KW - TC KW - TG KW - carotid atherosclerosis KW - coronary artery disease ITT, intention-to-treat KW - high-density lipoprotein cholesterol KW - impaired glucose tolerance KW - intention-to-treat KW - lipid-lowering drugs KW - low-density lipoprotein cholesterol KW - randomized controlled trials KW - total cholesterol KW - triglycerides KW - type 2 diabetes mellitus SP - 25 EP - 34 JF - Phytomedicine : international journal of phytotherapy and phytopharmacology JO - Phytomedicine VL - 50 N2 - BACKGROUND: In recent years, berberine has become widely used as an effective alternative to treat dyslipidaemias; much clinical evidence has emerged. It is important to systematically and critically evaluate the existing evidence. PURPOSE: This study aims to evaluate the efficacy and safety of berberine in patients with dyslipidaemias. STUDY DESIGN: A systematic review and meta-analysis of randomized clinical trials. METHODS: Five electronic databases were searched up to Apr 15, 2018 to identify randomized controlled trials (RCTs) of berberine in treatment of dyslipidaemias. The outcomes were lipid profile parameters and adverse events. Study selection, data collection, risk of bias assessment, data analyses and interpretations were conducted according to the Cochrane handbook. RESULTS: Sixteen trials with total of 2147 participants were judged to be eligible and were included in the meta-analysis. The included trials were assessed to be of high clinical heterogeneity. The methodological quality of the majority of the trials was generally low in terms of random sequence generation, allocation concealment, blinding and incomplete outcome data. Thus, selection bias, performance bias, detection bias, attrition bias and confounding bias might exist. Meta-analysis showed that berberine significantly reduced levels of total cholesterol (TC) (MD = -0.47 mmol/l 95% CI [-0.64, -0.31], p < 0.00001), low-density lipoprotein cholesterol (LDL-C) (MD =-0.38 mmol/l 95% CI [-0.53, -0.22], p < 0.00001) and triglycerides (TG) (MD = -0.28 mmol/l 95% CI [-0.46, -0.10], p = 0.002). Berberine also increased the level of high-density lipoprotein cholesterol (HDL-C) when used alone (MD = 0.08 mmol/l 95% CI [0.03, 0.12], p = 0.001). No significant differences were found between groups in terms of incidence of adverse events (RR = 0.64 95% CI [0.31, 1.30], p = 0.22). No severe adverse effects were reported in either group. CONCLUSION: Berberine improves lipid profiles in dyslipidaemias with satisfactory safety. Nevertheless, these findings should be interpreted with caution because of the high clinical heterogeneity and high risk of bias in the included trials. Rigorous clinical trials should be carried out to provide more reliable evidence. SN - 1618-095X UR - https://www.unboundmedicine.com/medline/citation/30466986/Efficacy_and_safety_of_berberine_for_dyslipidaemias:_A_systematic_review_and_meta_analysis_of_randomized_clinical_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0944-7113(18)30495-1 DB - PRIME DP - Unbound Medicine ER -