Effects of coenzyme Q10 supplementation on statin-induced myopathy: a meta-analysis of randomized controlled trials

Ir J Med Sci. 2022 Apr;191(2):719-725. doi: 10.1007/s11845-021-02651-x. Epub 2021 May 17.

Abstract

Background: Statins can trigger a series of muscle-related adverse events, commonly referred to collectively as statin-induced myopathy. Although coenzyme Q10 (CoQ10) is widely used as a supplement in statin therapy, there is little clinical evidence for this practice.

Aim: This study aims to assess the effect of adding CoQ10 on statin-induced myopathy.

Methods: Searching the PubMed, EMBASE, and the Cochrane Library databases to identify randomized controlled trials investigating the effect of adding CoQ10 on creatine kinase (CK) activity and degree of muscle pain as two indicators of statin-induced myopathy. Two reviewers will independently extract data from the included articles.

Results: Study screening included a randomized controlled trial of oral CoQ10 versus placebo in patients with statin-induced myopathy. We had a total of 8 studies in which 472 patients were treated with statins: 6 studies with 281 participants assessed the impact of adding CoQ10 on CK activity, and 4 studies with 220 participants were included to evaluate the impacts of CoQ10 addition on muscle pain. Compared with the controls, CK activity increased after adding CoQ10, but the change was not significant (mean difference, 3.29 U/L; 95% CI, - 29.58 to 36.17 U/L; P = 0.84). Similarly, the meta-analysis did not benefit CoQ10 over placebo in improving muscle pain (standardized mean difference, - 0.59; 95% CI, - 1.54 to 0.36; P = 0.22).

Conclusion: The outcomes of this meta-analysis of existing randomized controlled trials showed that supplementation with CoQ10 did not have any significant benefit in improving statin-induced myopathy.

Keywords: CoQ10; Meta-analysis; Myalgia; Statin; Statin-induced myopathy.

Publication types

  • Meta-Analysis

MeSH terms

  • Dietary Supplements
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Muscular Diseases* / chemically induced
  • Muscular Diseases* / drug therapy
  • Randomized Controlled Trials as Topic
  • Ubiquinone / analogs & derivatives

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Ubiquinone
  • coenzyme Q10