Effects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled Trials

Updated meta-analysis of 12 randomized controlled trials including adults treated with statins who reported muscle symptoms. The included populations were mostly patients with dyslipidemia or statin-treated patients with statin-associated muscle symptoms, with one study in athletes aged ≥50 years taking statins.

Coenzyme Q10 supplementation was evaluated at doses ranging from 100 to 600 mg/day for 30 days to 3 months. The active intervention was compared with placebo; the route was not stated in the source packet.

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.

The evidence base was small and heterogeneous, with variable populations, doses, and treatment durations across trials. Outcome measures and timepoints were not uniform, and the pooled analysis did not show benefit on the objective biomarker plasma CK. These limitations reduce certainty and generalizability.