AB0453 RED RICE YEAST. AN ALTERNATIVE IN RHEUMATOID ARTHRITIS AND HYPERLIPIDEMIA
Authors: Blanca Varas, María Martín Fuentes
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Lipid profile control is essential in patients diagnosed with inflammatory disease such as rheumatoid arthritis (RA), since cardiovascular events (CV) are still the first cause of mortality. According to the EULAR recommendations on CV risk, in those patients with a low or moderate CV risk index, for whom diet and exercise have not been effective to diminish low density lipoprotein (LDL) cholesterol below 190 and 100 respectively, we must prescribe a statin. These are the most commonly used drugs with undoubted benefits shown in medical literature. However, often-polymedicated patients may present intolerances or adverse side effects that limit their use. Red rice yeast, whose main active ingredient is monacolin K, has been used in traditional Chinese medicine since 800 AD as a remedy to reduce the total cholesterol level (TC) in blood, LDL and triglycerides (TG). In addition, some studies underline its anti-inflammatory effect and its benefit in patients with inflammatory pathology. In recent years, its use has spread throughout the western world. <h3>Objectives:</h3> To evaluate the efficacy of red rice yeast in patients with elevated levels of TC and LDL in rheumatology clinic. <h3>Methods:</h3> Prospective study that includes two cohorts of 30 patients with similar demographic characteristics. One cohort with RA patients and the other one without inflammatory disease. Both groups present high levels of TC and LDL. We study the demographic, clinical and lipid levels. A standard dose of red rice yeast is administered to every patient and we evaluate the analytical response after 3 and 6 months of treatment. For the statistical analysis, we used the SPSS program 22.0 version. Quantitative variables are presented as means ± standard deviation and qualitative variables as percentages. The comparisons between the quantitative variables are made with the Student's T-test. We compared the mean values for each visit with the Anova test. A p &lt;0.05 is considered significant. <h3>Results:</h3> In the group of patients without inflammatory pathology (n = 30), 73% are women with an average age of 63.9 ± 7 years. The mean of baseline TC is 265.2 mg/dL ± 13.7 and LDL 176.4 ± 16. After 3 and 6 months of treatment, a significant decrease in both values was obtained (TC 231 ± 19 and 209.8 ± 19 F: 26.71 p 0.000 and LDL 143.9 ± 20 and 123.6 ± 19 F 22.51 p 0.000) In the cohort of patients with RA (n = 30), 66% were women with an average age of 62.1 ± 10. The mean baseline TC is 258.2 ± 14 and LDL is 176.7 ± 10. After 3 and 6 months of treatment a significant decrease of both values was obtained (TC 224 ± 24 and 196.1 ± 28 F: 21.55 p 0.000 LDL 149.5 ± 12 and 122.4 ± 25 F: 28.28 p 0.000) There were no significant changes in HDL or TG levels. Neither adverse effects were detected nor treatment was abandoned. <h3>Conclusion:</h3> The red rice yeast significantly decreases the levels of TC and LDL in the two cohorts. In patients with RA and mild or moderate CV risk, where a close control is necessary, the use of red rice yeast could be an effective therapeutic alternative free of adverse side effects. More studies are needed with a greater number of patients to corroborate these data <h3>References</h3> [1] Agca R, Heslinga SC, Rollefstad S, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update Annals of the Rheumatic Diseases 2017;76:17-28. <h3>Disclosure of Interests:</h3> None declared