Effect of coenzyme q10 on myopathic symptoms in patients treated with statins.
Treatment of hypercholesterolemia with statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) is effective in the primary and secondary prevention of cardiovascular disease. However, statin use is often associated with a variety of muscle-related symptoms or myopathies. Myopathy may be related in part to statin inhibition of the endogenous synthesis of coenzyme Q10, an essential cofactor for mitochondrial energy production. The aim of this study is to determine whether coenzyme Q10 supplementation would reduce the degree of muscle pain associated with statin treatment. Patients with myopathic symptoms were randomly assigned in a double-blinded protocol to treatment with coenzyme Q10 (100 mg/day, n = 18) or vitamin E (400 IU/day, n = 14) for 30 days. Muscle pain and pain interference with daily activities were assessed before and after treatment. After a 30-day intervention, pain severity decreased by 40% (p <0.001) and pain interference with daily activities decreased by 38% (p <0.02) in the group treated with coenzyme Q10. In contrast, no changes in pain severity (+9%, p = NS) or pain interference with daily activities (-11%, p = NS) was observed in the group treated with vitamin E. In conclusion, results suggest that coenzyme Q10 supplementation may decrease muscle pain associated with statin treatment. Thus, coenzyme Q10 supplementation may offer an alternative to stopping treatment with these vital drugs.
Caso
Giuseppe
G
Department of Surgery, Division of Cardiology, Stony Brook University, Stony Brook, NY, USA. giuseppe.caso@stonybrook.edu
Kelly
Patricia
P
McNurlan
Margaret A
MA
Lawson
William E
WE
D000203:Activities of Daily Living; D000368:Aged; D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D003067:Coenzymes / Q000187:drug effects / Q000494:pharmacology / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D006937:Hypercholesterolemia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000139:chemically induced / Q000188:drug therapy / Q000503:physiopathology; D010147:Pain Measurement; D010349:Patient Compliance; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000187:drug effects / Q000494:pharmacology / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use; D014815:Vitamins / Q000494:pharmacology* / Q000627:therapeutic use
D015415:Biomarkers; D008078:Cholesterol, LDL; D003067:Coenzymes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D014815:Vitamins; D014451:Ubiquinone; D014810:Vitamin E; D003402:Creatine Kinase; C024989:coenzyme Q10