Effects of coenzyme Q10 supplementation on statin-induced myopathy: a meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Meta-analysis of randomized controlled trials
PubMed 33999383 · doi:10.1007/s11845-021-02651-x
What was done
A systematic review and meta-analysis of randomized controlled trials was conducted via searches in PubMed, EMBASE, and the Cochrane Library. The review included trials comparing oral CoQ10 supplementation against placebo in patients experiencing statin-induced myopathy. Data extraction was performed independently by two reviewers. Outcomes evaluated were creatine kinase (CK) activity and the degree of muscle pain across 8 included studies totaling 472 participants.
What was found
CoQ10 supplementation showed no statistically significant effect compared to placebo on either outcome: - Creatine kinase activity (6 studies, n = 281): mean difference 3.29 U/L (95% CI, -29.58 to 36.17 U/L; P = 0.84). - Muscle pain (4 studies, n = 220): standardized mean difference -0.59 (95% CI, -1.54 to 0.36; P = 0.22).
Why it matters
Despite the widespread clinical practice of recommending CoQ10 to alleviate statin-associated muscle symptoms, pooled trial evidence does not support its efficacy for relieving pain or reducing biomarker evidence of muscle damage.
Limits
The total evidence base is small, with only 472 total patients across 8 trials and fewer than 300 participants contributing to each specific endpoint. Confidence intervals for muscle pain relief were wide, reflecting imprecision. Details regarding CoQ10 dosing, treatment duration, specific statin regimens, and symptom severity scales 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.