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A randomized trial of coenzyme Q10 in patients with confirmed statin myopathy.
Atherosclerosis. 2015 Feb; 238(2):329-35.A

Abstract

BACKGROUND

Coenzyme Q10 (CoQ10) supplementation is the most popular therapy for statin myalgia among both physicians and patients despite limited and conflicting evidence of its efficacy.

OBJECTIVE

This study examined the effect of coenzyme Q10 (CoQ10) supplementation on simvastatin-associated muscle pain, muscle strength and aerobic performance in patients with confirmed statin myalgia.

METHODS

Statin myalgia was confirmed in 120 patients with prior symptoms of statin myalgia using an 8-week randomized, double-blind crossover trial of simvastatin 20 mg/d and placebo. Forty-one subjects developed muscle pain with simvastatin but not with placebo and were randomized to simvastatin 20 mg/d combined with CoQ10 (600 mg/d ubiquinol) or placebo for 8 weeks. Muscle pain (Brief Pain Inventory [BPI]), time to pain onset, arm and leg muscle strength, and maximal oxygen uptake (VO2max) were measured before and after each treatment.

RESULTS

Serum CoQ10 increased from 1.3 ± 0.4 to 5.2 ± 2.3 mcg/mL with simvastatin and CoQ10, but did not increase with simvastatin and placebo (1.3 ± 0.3 to 0.8 ± 0.2) (p < 0.05). BPI pain severity and interference scores increased with simvastatin therapy (both p < 0.01), irrespective of CoQ10 assignment (p = 0.53 and 0.56). There were no changes in muscle strength or VO2max with simvastatin with or without CoQ10 (all p > 0.10). Marginally more subjects reported pain with CoQ10 (14 of 20 vs 7 of 18; p = 0.05). There was no difference in time to pain onset in the CoQ10 (3.0 ± 2.0 weeks) vs. placebo (2.4 ± 2.1 wks) groups (p = 0.55). A similar lack of CoQ10 effect was observed in 24 subjects who were then crossed over to the alternative treatment.

CONCLUSIONS

Only 36% of patients complaining of statin myalgia develop symptoms during a randomized, double-blind crossover of statin vs placebo. CoQ10 supplementation does not reduce muscle pain in patients with statin myalgia. Trial RegistrationNCT01140308; www.clinicaltrials.gov.

Authors+Show Affiliations

Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA; Department of Health Sciences, University of Hartford, West Hartford, CT, USA; University of Connecticut School of Medicine, Farmington, CT, USA. Electronic address: Beth.taylor@hhchealth.org.Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA.Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA; University of Connecticut School of Medicine, Farmington, CT, USA.Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA; University of Connecticut School of Medicine, Farmington, CT, USA.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25545331

Citation

Taylor, Beth A., et al. "A Randomized Trial of Coenzyme Q10 in Patients With Confirmed Statin Myopathy." Atherosclerosis, vol. 238, no. 2, 2015, pp. 329-35.
Taylor BA, Lorson L, White CM, et al. A randomized trial of coenzyme Q10 in patients with confirmed statin myopathy. Atherosclerosis. 2015;238(2):329-35.
Taylor, B. A., Lorson, L., White, C. M., & Thompson, P. D. (2015). A randomized trial of coenzyme Q10 in patients with confirmed statin myopathy. Atherosclerosis, 238(2), 329-35. https://doi.org/10.1016/j.atherosclerosis.2014.12.016
Taylor BA, et al. A Randomized Trial of Coenzyme Q10 in Patients With Confirmed Statin Myopathy. Atherosclerosis. 2015;238(2):329-35. PubMed PMID: 25545331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized trial of coenzyme Q10 in patients with confirmed statin myopathy. AU - Taylor,Beth A, AU - Lorson,Lindsay, AU - White,C Michael, AU - Thompson,Paul D, Y1 - 2014/12/17/ PY - 2014/11/07/received PY - 2014/12/08/revised PY - 2014/12/09/accepted PY - 2014/12/30/entrez PY - 2014/12/30/pubmed PY - 2015/9/22/medline KW - Aerobic performance KW - CoQ10 KW - Exercise KW - Muscle pain KW - Muscle strength KW - Myalgia KW - Statin KW - Ubiquinol SP - 329 EP - 35 JF - Atherosclerosis JO - Atherosclerosis VL - 238 IS - 2 N2 - BACKGROUND: Coenzyme Q10 (CoQ10) supplementation is the most popular therapy for statin myalgia among both physicians and patients despite limited and conflicting evidence of its efficacy. OBJECTIVE: This study examined the effect of coenzyme Q10 (CoQ10) supplementation on simvastatin-associated muscle pain, muscle strength and aerobic performance in patients with confirmed statin myalgia. METHODS: Statin myalgia was confirmed in 120 patients with prior symptoms of statin myalgia using an 8-week randomized, double-blind crossover trial of simvastatin 20 mg/d and placebo. Forty-one subjects developed muscle pain with simvastatin but not with placebo and were randomized to simvastatin 20 mg/d combined with CoQ10 (600 mg/d ubiquinol) or placebo for 8 weeks. Muscle pain (Brief Pain Inventory [BPI]), time to pain onset, arm and leg muscle strength, and maximal oxygen uptake (VO2max) were measured before and after each treatment. RESULTS: Serum CoQ10 increased from 1.3 ± 0.4 to 5.2 ± 2.3 mcg/mL with simvastatin and CoQ10, but did not increase with simvastatin and placebo (1.3 ± 0.3 to 0.8 ± 0.2) (p < 0.05). BPI pain severity and interference scores increased with simvastatin therapy (both p < 0.01), irrespective of CoQ10 assignment (p = 0.53 and 0.56). There were no changes in muscle strength or VO2max with simvastatin with or without CoQ10 (all p > 0.10). Marginally more subjects reported pain with CoQ10 (14 of 20 vs 7 of 18; p = 0.05). There was no difference in time to pain onset in the CoQ10 (3.0 ± 2.0 weeks) vs. placebo (2.4 ± 2.1 wks) groups (p = 0.55). A similar lack of CoQ10 effect was observed in 24 subjects who were then crossed over to the alternative treatment. CONCLUSIONS: Only 36% of patients complaining of statin myalgia develop symptoms during a randomized, double-blind crossover of statin vs placebo. CoQ10 supplementation does not reduce muscle pain in patients with statin myalgia. Trial RegistrationNCT01140308; www.clinicaltrials.gov. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/25545331/A_randomized_trial_of_coenzyme_Q10_in_patients_with_confirmed_statin_myopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(14)01636-0 DB - PRIME DP - Unbound Medicine ER -