One hundred-forty three patients with hypercholesterolemia or combined hyperlipidemia were randomly assigned to receive, in double-blind fashion, sugar cane policosanol (10, 20, 40, or 80 mg/day) or placebo for 12 weeks. In none of the five treatment groups did the mean LDL-cholesterol level decrease more than 10% from baseline. No statistically significant differences between policosanol and placebo were observed with respect to the mean changes in total-, LDL-, or HDL-cholesterol, the ratio of LDL-cholesterol to HDL-cholesterol, or triglyceride levels. A test analyzing dose-dependency yielded nonsignificant results.

Comment: Policosanol is a mixture of long chain (C24 to C34) primary alcohols, originally isolated from sugar cane wax. These long-chain primary alcohols are also found in bee's wax, rice bran, and wheat germ. A number of studies have found that sugar cane policosanol lowers serum cholesterol levels as effectively as various statin drugs. However, all published studies demonstrating a beneficial effect of sugar cane policosanol have been authored by a single research group from Cuba. The results of the present study, as well as those of a similar study using wheat germ policosanol that I cited a few months ago in this column, suggest that policosanol is not an effective treatment for hyperlipidemia.

In my review of the wheat germ policosanol study, I requested feedback from readers about their experiences with policosanol. So far, I have received one correspondence, from a doctor who has observed that sugar cane policosanol, usually in doses of 20-40 mg/day, is very effective for lowering lipid levels.

Berthold HK, et al. Effect of policosanol on lipid levels among patients with hypercholesterolemia or combined hyperlipidemia: a randomized controlled trial. JAMA. 2006;295:2262-2269.