Statin therapy and plasma coenzyme Q10 concentrations—A systematic review and meta-analysis of placebo-controlled trials
Abstract
Statin therapy may lower plasma coenzyme Q10 (CoQ10) concentrations, but the evidence as to the significance of this effect is unclear. We assessed the impact of statin therapy on plasma CoQ10 concentrations through the meta-analysis of available RCTs. The literature search included selected databases up to April 30, 2015. The meta-analysis was performed using either a fixed-effects or random-effect model according to I(2) statistic. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence interval (CI). The data from 8 placebo-controlled treatment arms suggested a significant reduction in plasma CoQ10 concentrations following treatment with statins (WMD: -0.44 μmol/L, 95%CI: -0.52, -0.37, p<0.001). The pooled effect size was robust and remained significant in the leave-one-out sensitivity analysis. Subgroup analysis suggested that the impact of statins on plasma CoQ10 concentrations is significant for all 4 types of statins studied i.e. atorvastatin (WMD: -0.41 μmol/L, 95%CI: -0.53, -0.29, p<0.001), simvastatin (WMD: -0.47 μmol/L, 95% CI: -0.61, -0.33, p<0.001), rosuvastatin (WMD: -0.49 μmol/L, 95%CI: -0.67, -0.31, p<0.001) and pravastatin (WMD: -0.43 μmol/L, 95%CI: -0.69, -0.16, p=0.001). Likewise, there was no differential effect of lipophilic (WMD: -0.43 μmol/L, 95%CI: -0.53, -0.34, p<0.001) and hydrophilic statins (WMD: -0.47 μmol/L, 95%CI: -0.62, -0.32, p<0.001). With respect to treatment duration, a significant effect was observed in both subsets of trials lasting <12 weeks (WMD: -0.51 μmol/L, 95%CI: -0.64, -0.39, p<0.001) and ≥12 weeks (WMD: -0.40 μmol/L, 95%CI: -0.50, -0.30, p<0.001). The meta-analysis showed a significant reduction in plasma CoQ10 concentrations following treatment with statins. Further well-designed trials are required to confirm our findings and elucidate their clinical relevance.
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Statins reduce serum CoQ10 levels by −0.44 μmol/L (95% CI −0.52 to −0.37, p<0.001) according to a meta-analysis by Banach et al.
“A meta-analysis by Banach et al.(48) shows an overall reduction of serum CoQ10 levels by − 0.44 µmol/L (95% CI − 0.52; −0.37, p < 0.001) caused by statins.(48)”
From Effects of coenzyme Q10 supplementation on myopathy in statin-treated patients: a systematic review and meta-analysis (2025) · cites this paper as [48]
A meta-analysis of 6 randomized controlled trials suggested a significant reduction in plasma CoQ10 after statin treatment, regardless of statin solution, treatment duration, or treatment dose.
“a meta‐analysis6 of 6 RCTs also suggested a significant reduction in plasma CoQ10 after statin treatment, regardless of the statin solution, treatment duration, or treatment dose.”
From Effects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled Trials (2018) · cites this paper as [6]
Previous studies demonstrated a reduction in coenzyme Q10 after statin treatment, which might be associated with statin-induced myopathy.
“Previous studies4, 5, 6 have demonstrated a reduction in coenzyme Q10 (CoQ10) after statin treatment, which might be associated with statin‐induced myopathy.”
From Effects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled Trials (2018) · cites this paper as [6]
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Prosarcopenic Effects of Statins May Limit Their Effectiveness in Patients with Heart Failure
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Self-citation
- Authors
- Banach, M., Serban, C., Ursoniu, S., Rysz, J., Muntner, P., Toth, P. P., Jones, S. R., Rizzo, M., Glasser, S. P., Watts, G. F., Blumenthal, R. S., Lip, G. Y. H., Mikhailidis, D. P., & Sahebkar, A.
- Affiliations
- Medical University of Lodz (PL)
- Victor Babeș University of Medicine and Pharmacy Timișoara (RO)
- University of Alabama at Birmingham (US)
- Johns Hopkins University (US)
- Johns Hopkins Medicine (US)
- University of Palermo (IT)
- The University of Western Australia (AU)
- Birmingham City Hospital (GB)
- The Royal Free Hospital (GB)
- Mashhad University of Medical Sciences (IR)
- Corresponding author
- Banach, Maciej
- ORCID
- Venue
- Pharmacological Research
- Publisher
- Elsevier BV
- Published
- 2015-09
- Volume
- 99
- Pages
- 329-336
- ISSN
- 1043-6618 (ISSN-L)
- OpenAlex
- W1022878726
- Cited by
- 195
- References
- 50
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 12 · 2023: 26 · 2022: 22 · 2021: 18 · 2020: 19 · 2019: 3 · 2018: 17 · 2017: 22 · 2016: 25 · 2015: 5
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pharmacological Research (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Coenzyme Q10 studies and effects
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- statins, coenzyme Q10, atorvastatin, simvastatin, rosuvastatin, pravastatin, treatment duration, statin safety
- MeSH terms
- Adult, Aged, Double-Blind Method, Female, Humans, Male, Middle Aged, Ubiquinone, Placebo Effect, Case-Control Studies, Randomized Controlled Trials as Topic, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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