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Coenzyme Q10 not helpful for statin-associated muscle symptoms
Question clinique
Does coenzyme Q10 alleviate statin-associated myalgias?
L’Essentiel
There is no evidence, albeit from a limited evidence base, that coenzyme Q10 provides any benefit for patients with statin-associated muscle symptoms (SAMS). 1a-
Référence
Plan de l'etude: Meta-analysis (randomized controlled trials)
Financement: Self-funded or unfunded
Cadre: Various (meta-analysis)
Sommaire
SAMS may result in patients abandoning statin therapy. There is a physiologic rationale for coenzyme Q10 as a treatment for SAMS, but results from clinical trials have been mixed. Although a previous systematic review concluded that it was beneficial, that study included non–placebo controlled studies and studies in which coenzyme Q10 was administered with other interventions. The current systematic review was more rigorous and adhered to high standards for the study selection and the analysis. The authors identified 8 studies, of which 7 studies with 321 patients contributed to the final quantitative meta-analysis. Patients in the studies were taking a variety of statins at different doses; the dose of coenzyme Q10 ranged from 120 mg to 200 mg in 5 studies, 300 mg in one study, and 600 mg in one study. The studies were small with between 37 and 76 participants, and all but one had some concerns about validity, most commonly related to selective outcome reporting. The primary outcome was the weighted mean difference (WMD) between groups in myalgia scores and it did not differ significantly (WMD -0.42; 95% CI -1.47 to 0.62). Heterogeneity was high, primarily due to a single outlier study that showed a very large benefit, with the other 6 studies near the null. There was also no effect on adherence to the statin, a secondary outcome.
Reviewer
Mark H. Ebell, MD, MS
Professor
University of Georgia
Athens, GA
Commentaires
Coenzyme Q10 for SAMS
I presume the CoQ10 was administered by mouth.
absorption by that route is not reliable. It would be of interest to see the results when it is administered by intravenous infusion for SAMS.
supplements
No benefit noted. Is there any harm?
Muscle Cramps in general
As retired neurosurgeon consult I see patient with most are on statine , Q10 enzyme has been advertised and some people has tried that, they ask if it is useful I was aware of various study and my I knew there is no evidence this confirm that so I will use indiscussion and recomendation changing type lipid lowering drug.
statin associated muscle symptoms
Which statins have the lowest incidence of statin associated muscle symptoms?
Coenzyme Q10 and muscle cramps
The conclusion makes no biochemical sense. What is needed is a large prospective randomized study to settle the matter.
Very relevant, and echoed what I am seeing in practice with
It is nice to see a summary that has echoed my clinical observations in patients that experience statin-induced myalgia and tendonopathy. This was reassuring to read, as it validates my own opinion. I have discontinued recommending CoQ 10 for statin-related myalgia a long time ago - but always felt somewhat uncomfortable about it without a study to refer to. This was quite helpful in that regard.
coenzyme Q10 use with statin cramps
most studies do not show benefit but they were small studies