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Effects of morning vs evening statin administration on lipid profile: A systematic review and meta-analysis

      Highlights

      • Low-density lipoprotein cholesterol lowering was greater in the evening dose of short and long half-life statins.
      • Total cholesterol lowering was greater in the evening dose of short half-life statins only.
      • Morning dose was equivalent to evening dose in terms of high-density lipoprotein cholesterol and triglyceride.

      Background

      Evidence about the optimal time of day at which to administer statins is lacking.

      Objective

      The objective of this study is to synthesize evidence about effects of morning vs evening statin administration on lipid profile.

      Methods

      We searched PubMed, SCOPUS, Web of Science, and Embase databases (from inception up to July 24, 2016) to identify the relevant studies. Mean differences (MDs) between the change scores in lipid parameters were pooled using a fixed-effect model.

      Results

      Eleven articles with 1034 participants were eligible for the analysis. The pooled analysis comparing effects of morning vs evening administration of statins on plasma total cholesterol (TC; P = .10), high-density lipoprotein cholesterol (P = .90), and triglycerides (P = .45) was not statistically significant. Low-density lipoprotein cholesterol (LDL-C) lowering was statistically greater in the evening-dose group (MD: 3.24 mg/dL, 95% CI: 1.23–5.25, P = .002). Subgroup analysis according to statin half-lives showed that evening dose of statins was significantly superior to morning dose for lowering LDL-C in case of both short and long half-life statins (MD: 9.68 mg/dL, 95% CI: 3.32–16.03, P = .003 and MD: 2.53 mg/dL, 95% CI: 0.41–4.64, P = .02, respectively) and also for TC reduction in case of short half-life statins only (P = .0005).

      Conclusions

      LDL-C and TC lowering was significantly greater in the evening dose than in the morning dose in case of short-acting statins. Besides slight but significant effect on LDL-C, the efficacy of long-acting statins was equivalent for both regimens. Therefore, long-acting statins should be given at a time that will best aid compliance. Short-acting statins should be given in the evening.

      Keywords

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