Effect of coenzyme Q10 supplementation in patients with statin-related myalgia

Abstract

Statins (Hydroxy‐methylglutaryl CoA reductase inhibitors) are routinely prescribed to treat hypercholesterolemia because they inhibit endogenous cholesterol synthesis but in some patients their use is associated with increased incidence of myalgia and myopathic symptoms. Statins also inhibit the synthesis of CoQ10 and CoQ10 depletion may be a contributing factor to statin‐related myopathy. The aim of this study was to evaluate the ability of supplementation with coQ10 to reduce muscle symptoms associated with statin use. In a randomized double‐blind placebo controlled trial, statin‐treated patients complaining of myopathic symptoms (i.e. pain, fatigue, weakness) were supplemented with coQ10 (ubiquinol, 300 mg/d) or placebo for 1 month. Muscle pain was assessed before and after supplementation with the validated Brief Pain Inventory, Short Form. Patients in the two groups were comparable for age (55±2 vs. 57±2 y), BMI (31±1 vs. 29±1), gender and statin use. After 1 month of supplementation, CoQ10 plasma levels were significantly elevated in patients treated with CoQ10 (P<0.001). The intensity of pain (i.e. Pain Severity Score, PSS) was significantly reduced both in the CoQ10 (3.78 ± 0.47 vs. 2.72 ± 0.56, n=19) and placebo (3.97 ± 0.39 vs. 1.99 ± 0.46, n=18) groups, P<0.01. However, the changes in PSS before and after intervention were comparable between the two groups. The results of the study suggest that in this population, improvement in statin‐related myalgia with supplementation with CoQ10 was not superior to placebo. Supported by NIH grants 5R21AT004204 and 5‐MO1‐RR‐10710. CoQ10 was kindly provided by Kaneka Corp. (Pasadena, TX)