Effects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled Trials

Abstract

Background Previous studies have demonstrated a possible association between the induction of coenzyme Q10 (CoQ10) after statin treatment and statin‐induced myopathy. However, whether CoQ10 supplementation ameliorates statin‐induced myopathy remains unclear. Methods and Results PubMed, EMBASE , and Cochrane Library were searched to identify randomized controlled trials investigating the effect of CoQ10 on statin‐induced myopathy. We calculated the pooled weighted mean difference ( WMD ) using a fixed‐effect model and a random‐effect model to assess the effects of CoQ10 supplementation on statin‐associated muscle symptoms and plasma creatine kinase. The methodological quality of the studies was determined, according to the Cochrane Handbook . Publication bias was evaluated by a funnel plot, Egger regression test, and the Begg‐Mazumdar correlation test. Twelve randomized controlled trials with a total of 575 patients were enrolled; of them, 294 patients were in the CoQ10 supplementation group and 281 were in the placebo group. Compared with placebo, CoQ10 supplementation ameliorated statin‐associated muscle symptoms, such as muscle pain ( WMD , −1.60; 95% confidence interval [ CI ], −1.75 to −1.44; P <0.001), muscle weakness ( WMD , −2.28; 95% CI , −2.79 to −1.77; P =0.006), muscle cramp ( WMD , −1.78; 95% CI , −2.31 to −1.24; P <0.001), and muscle tiredness ( WMD , −1.75; 95% CI , −2.31 to −1.19; P <0.001), whereas no reduction in the plasma creatine kinase level was observed after CoQ10 supplementation ( WMD , 0.09; 95% CI , −0.06 to 0.24; P =0.23). Conclusions CoQ10 supplementation ameliorated statin‐associated muscle symptoms, implying that CoQ10 supplementation may be a complementary approach to manage statin‐induced myopathy.

Increased beneficial outcome of metformin by co-enzyme Q10 against experimentally-induced hind limb ischemia reperfusion injury in normal and diabetic rats

“…This result is supported by clinical trials showing that tested drug may improve statin induced myopathy. 38 The results of metformin treatment in DM+I/R group was in line with that of Q10. Metformin caused significantly more improvement in glycemic control, muscle parameter CKMM and IL6 and most of oxidative stress parameters.…”

Alleviation of Simvastatin-Induced Myopathy in Rats by the Standardized Extract of Ginkgo Biloba (EGb761): Insights into the Mechanisms of Action

“…Furthermore, Abdel-Kader et al [2007] reported that EGb761 restored mitochondrial functions in an in vitro model of aging. Recently, a metaanalysis of RCTs showed that CoQ 10 supplementation alleviated statin-induced muscle symptoms [Qu et al, 2018a]. Altogether, it is likely that EGb761 elevated CoQ 10 levels, possibly through augmenting CoQ 10 biosynthesis.…”

Muscle cramps — a mini review of possible causes and treatment options available with a special emphasis on diabetics — a narrative review

“…atorvastatin) used in the treatment of hypercholesterolemia in type 2 diabetes [68,69]. Hence, CoQ10 supplementation for statin induced muscle symptoms have opened a new avenue in the complementary management of statin-induced myopathy in type 2 diabetic patients [70].…”