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.

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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.

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 “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