Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 32179207 · doi:10.1016/j.atherosclerosis.2020.03.006
What was done
Systematic review and meta-analysis of randomized controlled trials identified via MEDLINE, EMBASE, and Cochrane Library searches following PRISMA guidelines. The review examined trials comparing oral CoQ10 supplementation against placebo in adults with statin-associated myalgia. Risk of bias was evaluated using the Cochrane Risk of Bias tool, with continuation of statin therapy assessed as a secondary outcome.
What was found
Eight studies met systematic review criteria, and 7 trials (321 total participants; study sizes ranging from 37 to 76) were meta-analyzed. Only 2 of 8 studies found a positive effect of CoQ10 on muscle pain. Pooled meta-analysis demonstrated no significant benefit of CoQ10 versus placebo for myalgia symptoms (weighted mean difference -0.42; 95% CI -1.47 to 0.62) or statin therapy continuation (RR 0.99; 95% CI 0.81 to 1.20).
Why it matters
CoQ10 is widely recommended in practice for statin-induced muscle symptoms, but pooled trial evidence shows it is no more effective than placebo for symptom relief or improving statin persistence.
Limits
The total sample size across all trials was small (321 patients in the meta-analysis), and individual studies were limited in size (37-76 patients). Details on specific CoQ10 doses, treatment durations, and types of statins used were not provided in the abstract.
Cited by
- supports Clinical trials evaluating ubiquinol or CoQ10 supplementation in statin users have shown no difference in reducing the incidence of statin-associated muscle soreness.