Faculty of Medicine, Zagazig University, Egypt.
Head Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz (MUL).
Curr Opin Lipidol. 2018 Aug;29(4):340-345. doi: 10.1097/MOL.0000000000000524.
In humans, cholesterol biosynthesis varies diurnally, reaching its peak at night. Therefore, choosing the time of statin administration is critical because of their different half-lives. Dose timing becomes more important in patients with polypharmacy because it might affect their adherence to the statin therapy.
Herein, we narratively summarized the available clinical studies (n = 17) and meta-analyses (n = 2) that compared the morning with the evening dose of statins in terms of safety and efficacy, with special focus on their low-density lipoprotein-lowering effects. We also explained the difference in efficacy results in case of short-acting compared with the long-acting statins and highlighted how flexibility in choosing the time of statin administration is important for better adherence.
The current limited evidence suggests that short-acting statins should be given in the evening whereas long-acting statins could be given at any time of the day with allowing more patient-based choice (of timing) for better adherence. Lager RCTs with longer durations are recommended to extend and confirm the current evidence.
在人类中，胆固醇生物合成呈昼夜节律变化，夜间达到峰值。因此，由于他汀类药物半衰期不同，选择他汀类药物给药时间至关重要。对于同时服用多种药物的患者，给药时间更为重要，因为这可能会影响他们对他汀类药物治疗的依从性。
本文通过叙述性总结了 17 项临床研究（n=17）和 2 项荟萃分析（n=2），比较了他汀类药物在安全性和疗效方面的晨服和晚服，特别关注了它们对低密度脂蛋白的降低作用。我们还解释了短效与长效他汀类药物疗效结果的差异，并强调了他汀类药物给药时间的灵活性对提高依从性的重要性。
目前有限的证据表明，短效他汀类药物应在晚上服用，而长效他汀类药物可以在一天中的任何时间服用，以允许更多基于患者的选择（时间）以提高依从性。建议进行更长时间的大型 RCT 以扩展和确认目前的证据。
