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Effects of Coenzyme Q10 on Statin-Induced Myopathy

A Meta-analysis of Randomized Controlled Trials
Published:November 13, 2014DOI:https://doi.org/10.1016/j.mayocp.2014.08.021

      Abstract

      Objective

      To evaluate the efficacy of coenzyme Q10 (CoQ10) supplementation on statin-induced myopathy.

      Participants and Methods

      We searched the MEDLINE, Cochrane Library, Scopus, and EMBASE databases (November 1, 1987, to May 1, 2014) to identify randomized controlled trials investigating the impact of CoQ10 on muscle pain and plasma creatine kinase (CK) activity as 2 measures of statin-induced myalgia. Two independent reviewers extracted data on study characteristics, methods, and outcomes.

      Results

      We included 6 studies with 302 patients receiving statin therapy: 5 studies with 226 participants evaluated the effect of CoQ10 supplementation on plasma CK activity, and 5 studies (4 used in the CK analysis and 1 other study) with 253 participants were included to assess the effect of CoQ10 supplementation on muscle pain. Compared with the control group, plasma CK activity was increased after CoQ10 supplementation, but this change was not significant (mean difference, 11.69 U/L [to convert to μkat/L, multiply by 0.0167]; 95% CI, –14.25 to 37.63 U/L; P=.38). Likewise, CoQ10 supplementation had no significant effect on muscle pain despite a trend toward a decrease (standardized mean difference, –0.53; 95% CI, –1.33 to 0.28; P=.20). No dose-effect association between changes in plasma CK activity (slope, –0.001; 95% CI, –0.004 to 0.001; P=.33) or in the indices of muscle pain (slope, 0.002; 95% CI, –0.005 to 0.010; P=.67) and administered doses of CoQ10 were observed.

      Conclusion

      The results of this meta-analysis of available randomized controlled trials do not suggest any significant benefit of CoQ10 supplementation in improving statin-induced myopathy. Larger, well-designed trials are necessary to confirm the findings from this meta-analysis.

      Abbreviations and Acronyms:

      BMI (body mass index), CK (creatine kinase), CoQ10 (coenzyme Q10), RCT (randomized controlled trial), VAS (visual analog scale)
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      Linked Article

      • Coenzyme Q10 and Statin-Induced Myopathy—II
        Mayo Clinic ProceedingsVol. 90Issue 3
        • Preview
          Myopathy is a major clinical problem that contributes considerably to statin therapy discontinuation. Banach et al1 must be commended for their meta-analysis of randomized controlled trials (6 studies with 302 patients) investigating the impact of coenzyme Q10 (CoQ10) on statin-induced myalgia. They concluded that the results do not suggest any significant benefit: CoQ10 supplementation had no significant effect on muscle pain despite a trend toward a decrease (standardized mean difference, −0.53).
        • Full-Text
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      • Coenzyme Q10 and Statin-Induced Myopathy—I
        Mayo Clinic ProceedingsVol. 90Issue 3
        • Preview
          The meta-analysis and review by Banach et al1 published in the January 2015 issue of Mayo Clinic Proceedings presented interesting but disappointing results for those who hoped that coenzyme Q10 (CoQ10) would prove to be the antidote for the muscle pains and myopathy induced by statin use in susceptible patients.
        • Full-Text
        • PDF