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

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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.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CoQ10:

Coenzyme Q10

CK:

Creatine kinase

LDL:

Low-density lipoprotein

CAD:

Coronary artery disease

LDL-C:

LDL-cholesterol

CHD:

Coronary heart disease

GTP:

Guanosine triphosphate

RCTs:

Randomized controlled trials

SD:

Standard deviation

WMD:

Weighted mean difference

SMD:

Standardized mean difference

CVD:

Cardiovascular disease

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Acknowledgements

All authors thank and acknowledge their respective universities and institutes.

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Author notes

  1. Han Wei, Xiaojun Xin, and Jing Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, The Sir Run Run Hospital, Nanjing Medical University, Nanjing, China

    Han Wei, Xiaojun Xin, Qingya Xie & Pingxi Xiao

  2. Department of Clinical Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing, China

    Jing Zhang & Muhammad Naveed

  3. First School of Clinical Medicine, Nanjing Medical University, Nanjing, China

    Chen Kaiyan

Authors
  1. Han Wei
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  2. Xiaojun Xin
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  3. Jing Zhang
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  4. Qingya Xie
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  5. Muhammad Naveed
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  6. Chen Kaiyan
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  7. Pingxi Xiao
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Contributions

Han Wei and Pingxi Xiao contributed to the design of the study. Xiaojun Xin, Qingya Xie, and Jing Zhang managed the article search and helped to draft the manuscript. Muhammad Naveed, Jing Zhang and Chen Kaiyan contributed to revising the manuscript. All authors have approved the final manuscript.

Corresponding author

Correspondence to Pingxi Xiao.

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The authors declare no competing interests.

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Wei, H., Xin, X., Zhang, J. et al. Effects of coenzyme Q10 supplementation on statin-induced myopathy: a meta-analysis of randomized controlled trials. Ir J Med Sci 191, 719–725 (2022). https://doi.org/10.1007/s11845-021-02651-x

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  • DOI: https://doi.org/10.1007/s11845-021-02651-x

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