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. 2020 Apr;299:1-8.
doi: 10.1016/j.atherosclerosis.2020.03.006. Epub 2020 Mar 7.

Effect of Coenzyme Q10 on Statin-Associated Myalgia and Adherence to Statin Therapy: A Systematic Review and Meta-Analysis


Effect of Coenzyme Q10 on Statin-Associated Myalgia and Adherence to Statin Therapy: A Systematic Review and Meta-Analysis

Cormac Kennedy et al. Atherosclerosis. .


Background and aims: Statin associated muscle symptoms are common and affect adherence to statin treatment. The objective of this study was to assess whether patients with statin-associated myalgia can be successfully treated with Coenzyme Q10 (CoQ10) to improve symptoms and maintain them on statin therapy.

Methods: This systematic review was performed in line with the 2015 PRISMA statement. Relevant studies were identified via a search of MEDLINE, EMBASE and the Cochrane Library. Studies were screened to include randomised controlled trials of oral CoQ10 supplementation versus a placebo in adults with statin-associated myalgia. Continuation of statin therapy was a secondary outcome. Risk of bias was assessed using the Cochrane Risk of Bias tool. Pooled and sensitivity analyses were performed.

Results: 413 records were identified by the search strategy. Eight studies were selected for review, and 7 of them (with 321 patients) were included in the meta-analysis. Selected studies were published between 2007 and 2016 with the number of participants ranging from 37 to 76. Only two of these studies demonstrated a positive effect of CoQ10 therapy in relieving muscle pain. The meta-analysis did not demonstrate any benefit of CoQ10 supplementation in improving myalgia symptoms compared to placebo (weighted mean difference -0.42; 95% Confidence Interval [CI] -1.47 to 0.62). Similarly, CoQ10 did not improve the proportion of patients remaining on the statin treatment (RR 0.99; 95%CI, 0.81 to 1.20).

Conclusions: This systematic review and meta-analysis did not demonstrate that CoQ10 supplementation was beneficial for patients with statin-associated muscle pain or improved adherence to statin therapy.

Keywords: Adherence; CoQ10; Coenzyme Q10; Hypercholesterolemia; Myalgia; Myopathy; Statin; Ubiquinone.

Conflict of interest statement

Declaration of competing interest The authors declared they do not have anything to disclose regarding conflict of interest with respect to this manuscript.

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