Can serrapeptase help dissolve artery plaque?

No Evidence Supports Serrapeptase for Dissolving Arterial Plaque

There are no published studies—good, bad, or otherwise—demonstrating that serrapeptase dissolves arterial plaque in humans. The claim that serrapeptase can reduce atherosclerotic plaque is entirely unsupported by clinical evidence and represents marketing fiction rather than medical fact.

What the Evidence Actually Shows

Complete Absence of Plaque-Related Studies

• A comprehensive systematic review of all published serrapeptase literature found zero clinical trials examining its effects on atherosclerotic plaque, arterial stenosis, or cardiovascular outcomes 1
• The review explicitly noted that while serrapeptase is "promoted as a health supplement to prevent cardiovascular morbidity," there is no scientific evidence supporting anti-atherosclerotic efficacy 1
• The authors concluded that "evidence based recommendations on the anti-atherosclerotic efficacy, safety and tolerability of Serratiopeptidase are needed" because none currently exist 1

What Serrapeptase Actually Does (and Doesn't Do)

• Serrapeptase is a bacterial metalloprotease with documented anti-inflammatory and anti-edema properties in limited small studies 1, 2
• The enzyme breaks down fibrin and thins inflammatory fluids, which has led to speculative claims about cardiovascular effects based purely on its fibrinolytic properties—not actual clinical data 1, 2
• A 2024 review confirmed serrapeptase has anti-coagulant activity in laboratory settings but provided no human cardiovascular outcome data 2

The Quality of Existing Serrapeptase Research

• The systematic review graded existing serrapeptase studies and found they are "of poor methodology" with small sample sizes, undefined outcomes, and lack of safety data 1
• Most studies focus on post-surgical swelling, dental pain, or sinusitis—not cardiovascular disease 1, 3
• No randomized controlled trials have examined serrapeptase effects on plaque burden, coronary stenosis, carotid intima-media thickness, or any validated cardiovascular endpoint 1

Why This Matters Clinically

Evidence-Based Plaque Management

• Established guidelines for atherosclerotic disease management emphasize statins (targeting LDL <55 mg/dL), antiplatelet therapy, and revascularization when indicated 4
• The 2024 ESC guidelines for peripheral arterial disease make no mention of proteolytic enzymes for plaque management 4
• ACC/AHA guidelines consistently recommend aspirin, anticoagulation, and lipid-lowering therapy for thrombosis on atherosclerotic plaques—not enzymes 4

The Danger of Unproven Supplements

• Patients taking serrapeptase instead of proven therapies (statins, antiplatelet agents) face substantially increased risk of cardiovascular events and death 4
• The enzyme's proteolytic activity could theoretically increase bleeding risk when combined with antiplatelet therapy, though safety data is lacking 1
• Marketing serrapeptase as a cardiovascular supplement represents a dangerous distraction from evidence-based care 1

Common Pitfalls to Avoid

• Do not recommend serrapeptase for any cardiovascular indication—the evidence simply does not exist 1
• Do not accept "fibrinolytic activity" as proof of clinical cardiovascular benefit—this represents a mechanistic fallacy without outcome data 1, 2
• Do not delay proven therapies (statins, aspirin, revascularization) while patients experiment with unproven supplements 4

What to Tell Patients

• No human studies have tested whether serrapeptase affects arterial plaque 1
• The supplement industry promotes serrapeptase for cardiovascular health based on laboratory properties, not clinical outcomes 1
• Proven treatments for atherosclerosis include high-intensity statins, antiplatelet therapy, blood pressure control, and smoking cessation 4
• Spending money on serrapeptase diverts resources from medications with robust mortality benefits 1