Internal medicine

Pathology

Placebo

Cochrane Library

Gastroenterology

Meta-analysis

Physical therapy

Randomized controlled trial

Alternative medicine

Myopathy

Statin

Coenzyme Q10

Creatine kinase

Publication bias

Confidence interval

Medicine

Journal of the American Heart Association

Background Previous studies have demonstrated a possible association between the induction of coenzyme Q10 (CoQ10) after statin treatment and statin‐induced myopathy. However, whether CoQ10 supplementation ameliorates statin‐induced myopathy remains unclear. Methods and Results PubMed, EMBASE , and Cochrane Library were searched to identify randomized controlled trials investigating the effect of CoQ10 on statin‐induced myopathy. We calculated the pooled weighted mean difference ( WMD ) using a fixed‐effect model and a random‐effect model to assess the effects of CoQ10 supplementation on statin‐associated muscle symptoms and plasma creatine kinase. The methodological quality of the studies was determined, according to the Cochrane Handbook . Publication bias was evaluated by a funnel plot, Egger regression test, and the Begg‐Mazumdar correlation test. Twelve randomized controlled trials with a total of 575 patients were enrolled; of them, 294 patients were in the CoQ10 supplementation group and 281 were in the placebo group. Compared with placebo, CoQ10 supplementation ameliorated statin‐associated muscle symptoms, such as muscle pain ( WMD , −1.60; 95% confidence interval [ CI ], −1.75 to −1.44; P &lt;0.001), muscle weakness ( WMD , −2.28; 95% CI , −2.79 to −1.77; P =0.006), muscle cramp ( WMD , −1.78; 95% CI , −2.31 to −1.24; P &lt;0.001), and muscle tiredness ( WMD , −1.75; 95% CI , −2.31 to −1.19; P &lt;0.001), whereas no reduction in the plasma creatine kinase level was observed after CoQ10 supplementation ( WMD , 0.09; 95% CI , −0.06 to 0.24; P =0.23). Conclusions CoQ10 supplementation ameliorated statin‐associated muscle symptoms, implying that CoQ10 supplementation may be a complementary approach to manage statin‐induced myopathy.

Effects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled Trials