Coenzyme Q10 (CoQ10) supplementation was not found to improve statin therapy adherence or relieve associated muscle pain in patients with statin-associated myalgia, according to a systematic review and meta-analysis published in Atherosclerosis.
Myalgia associated with statin use is a common cause of statin cessation in patients with hypercholesterolemia. In this study, researchers performed a systematic review of 8 randomized controlled trials (RCTs) and a meta-analysis of 7 RCTs in which the effect of CoQ10 (n=165) vs placebo (n=156) on muscle pain in patients who reported statin-associated myalgia was examined. In the included RCTs, pain was evaluated using validated pain rating scales.
In 2 of the studies examined, CoQ10 supplementation was found to relieve muscle pain. CoQ10 therapy was not found to be superior to placebo in alleviating muscle pain in the meta-analysis (weighted mean difference [WMD], -0.42; 95% CI, -1.47-0.62; P =.000) or in a fixed effect model (WMD, -0.30; 95% CI -0.65-0.05; P =.00). The percentage of patients adhering to statin therapy was not found to be improved with CoQ10 supplementation vs placebo in the meta-analysis (relative ratio, 0.99; 95% CI, 0.81-1.20; P =.348) or with the fixed effect model.
Study limitations include the use of subjective visual analog scale scores for the assessment of pain, small sample sizes, and the lack of data on treatment adherence in some studies.
“CoQ10 is a potential treatment for statin intolerance, allowing patients to continue on a statin rather than switch to expensive biological therapies,” noted the study authors.
Kennedy C1, Köller Y2, Surkova E, et al. Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: a systematic review and meta-analysis [published online March 7, 2020]. Atherosclerosis. doi:10.1016/j.atherosclerosis.2020.03.006