title: Effects of coenzyme Q10 on statin-induced myopathy: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To evaluate the efficacy of coenzyme Q10 (CoQ10) supplementation on statin-induced myopathy.
  
  
  METHODS
  We searched the MEDLINE, Cochrane Library, Scopus, and EMBASE databases (November 1, 1987, to May 1, 2014) to identify randomized controlled trials investigating the impact of CoQ10 on muscle pain and plasma creatine kinase (CK) activity as 2 measures of statin-induced myalgia. Two independent reviewers extracted data on study characteristics, methods, and outcomes.
  
  
  RESULTS
  We included 6 studies with 302 patients receiving statin therapy: 5 studies with 226 participants evaluated the effect of CoQ10 supplementation on plasma CK activity, and 5 studies (4 used in the CK analysis and 1 other study) with 253 participants were included to assess the effect of CoQ10 supplementation on muscle pain. Compared with the control group, plasma CK activity was increased after CoQ10 supplementation, but this change was not significant (mean difference, 11.69 U/L [to convert to μkat/L, multiply by 0.0167]; 95% CI, -14.25 to 37.63 U/L; P=.38). Likewise, CoQ10 supplementation had no significant effect on muscle pain despite a trend toward a decrease (standardized mean difference, -0.53; 95% CI, -1.33 to 0.28; P=.20). No dose-effect association between changes in plasma CK activity (slope, -0.001; 95% CI, -0.004 to 0.001; P=.33) or in the indices of muscle pain (slope, 0.002; 95% CI, -0.005 to 0.010; P=.67) and administered doses of CoQ10 were observed.
  
  
  CONCLUSIONS
  The results of this meta-analysis of available randomized controlled trials do not suggest any significant benefit of CoQ10 supplementation in improving statin-induced myopathy. Larger, well-designed trials are necessary to confirm the findings from this meta-analysis.
authors.affiliation: Department of Hypertension, Medical University of Lodz, Lodz, Poland. Electronic address: maciejbanach@aol.co.uk.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
authors.affiliation: Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania; Centre for Interdisciplinary Research, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Corina
authors.initials: C
authors.lastname: Serban
authors.affiliation: Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Sahebkar
authors.affiliation: Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Sorin
authors.initials: S
authors.lastname: Ursoniu
authors.affiliation: Department of Nephrology, Hypertension, and Family Medicine, Medical University of Lodz, Lodz, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Rysz
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.affiliation: Preventive Cardiology, CGH Medical Center, Sterling, IL.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Toth
authors.affiliation: Preventive Cardiology, CGH Medical Center, Sterling, IL; The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Jones
authors.affiliation: Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.affiliation: Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Glasser
authors.affiliation: University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.affiliation: Centre for Interdisciplinary Research, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania; Department of Cardiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Simona
authors.initials: S
authors.lastname: Dragan
authors.affiliation: Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, UK.
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
mesh_terms: D052283:Creatine Kinase, MM Form / Q000097:blood*; D019587:Dietary Supplements; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D063806:Myalgia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014815:Vitamins; D014451:Ubiquinone; D052283:Creatine Kinase, MM Form; C024989:coenzyme Q10