Effects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled Trials
What this study found
Coenzyme Q10 was associated with improvement in statin-associated muscle symptoms, but it did not reduce plasma creatine kinase. In the fixed-effect analysis, muscle pain improved (WMD -1.60; 95% CI -1.75 to -1.44; P<0.001), muscle weakness improved (WMD -2.28; 95% CI -2.79 to -1.77; P=0.006), muscle cramps improved (WMD -1.78; 95% CI -2.31 to -1.24; P<0.001), and muscle tiredness improved (WMD -1.75; 95% CI -2.31 to -1.19; P<0.001). Plasma CK was not reduced (WMD 0.09; 95% CI -0.06 to 0.24; P=0.23). The authors concluded that CoQ10 may be a complementary approach for statin-induced myopathy.
- Study & population
- Updated meta-analysis of 12 randomized controlled trials including adults treated with statins who reported muscle symptoms.
- Intervention
- Coenzyme Q10 supplementation was evaluated at doses ranging from 100 to 600 mg/day for 30 days to 3 months.
- Key limitation
- The evidence base was small and heterogeneous, with variable populations, doses, and treatment durations across trials.
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Open PDFOriginal abstract
Background Previous studies have demonstrated a possible association between the induction of coenzyme Q10 (CoQ10) after statin treatment and statin‐induced myopathy. However, whether CoQ10 supplementation ameliorates statin‐induced myopathy remains unclear. Methods and Results PubMed, EMBASE, and Cochrane Library were searched to identify randomized controlled trials investigating the effect of CoQ10 on statin‐induced myopathy. We calculated the pooled weighted mean difference (WMD) using a fixed‐effect model and a random‐effect model to assess the effects of CoQ10 supplementation on statin‐associated muscle symptoms and plasma creatine kinase. The methodological quality of the studies was determined, according to the Cochrane Handbook. Publication bias was evaluated by a funnel plot, Egger regression test, and the Begg‐Mazumdar correlation test. Twelve randomized controlled trials with a total of 575 patients were enrolled; of them, 294 patients were in the CoQ10 supplementation group and 281 were in the placebo group. Compared with placebo, CoQ10 supplementation ameliorated statin‐associated muscle symptoms, such as muscle pain (WMD, −1.60; 95% confidence interval [CI], −1.75 to −1.44; P<0.001), muscle weakness (WMD, −2.28; 95% CI, −2.79 to −1.77; P=0.006), muscle cramp (WMD, −1.78; 95% CI, −2.31 to −1.24; P<0.001), and muscle tiredness (WMD, −1.75; 95% CI, −2.31 to −1.19; P<0.001), whereas no reduction in the plasma creatine kinase level was observed after CoQ10 supplementation (WMD, 0.09; 95% CI, −0.06 to 0.24; P=0.23). Conclusions CoQ10 supplementation ameliorated statin‐associated muscle symptoms, implying that CoQ10 supplementation may be a complementary approach to manage statin‐induced myopathy.