Coenzyme Q10 improves myopathic pain in statin-treated patients

March 28, 2005

Mar 28, 2005

Orlando, FL - Thirty-day coenzyme Q10 supplementation in statin-treated patients with myopathic symptoms results in a significant reduction in myopathic pain, according to the results of a recent study. The addition of coenzyme Q10 may represent a supplemental treatment to improve muscle-related side effects associated with statin use in certain patients, say investigators.

"We're trying to address a very important clinical question—that is, what do we do with these patients who are on statins and develop side effects?" Dr Patricia Kelly (University Hospital Medical Center, Stony Brook, NY) told rheuma wire . "There are some solutions, such as taking the patient off the drug, switching statins, or adjusting the dose, but we often see lipid levels rise when this happens. We're looking for an alternative to reducing the symptoms of myopathy associated with statin use that would retain the beneficial effects of cholesterol lowering."

Coenzyme Q10 allows clinicians to address the significant pain some patients experience when treated with statins while keeping them on the drug and keeping their cholesterol levels in check.

In this small double-blind study, presented earlier this month at the American College of Cardiology 2005 Scientific Sessions, researchers randomized 41 statin-treated patients with myopathic pain to 30 days of supplementation with 400 IU of vitamin E or 100 mg daily of coenzyme Q10. Baseline demographic and clinical parameters, including plasma lipid levels and creatine phosphokinase levels, were similar in both treatment groups.

Using a validated pain questionnaire from the University of Wisconsin, researchers report that myopathic pain significantly improved from baseline in patients treated with coenzyme Q10 (6.2 versus 3.1, p<0.001), whereas myopathic symptoms did not improve in patients randomized to vitamin-E supplementation. Overall, 18 of 21 patients taking coenzyme Q10 had improved pain scores compared with just 3 patients taking vitamin E. Creatine phosphokinase levels did not change with treatment and did not correlate with the severity of pain. LDL cholesterol levels were unchanged in both treatment groups.

"The incidence of myalgias in clinical trials is typically very low, but we know that it is often higher in practice," said Kelly. "Coenzyme Q10 allows clinicians to address the significant pain some patients experience when treated with statins while keeping them on the drug and keeping their cholesterol levels in check."

Kelly said next steps involve studies that obtain muscle biopsies, as well as serum and mitochondrial measurements of coenzyme Q10. In this study, due to the small numbers, the benefit of coenzyme Q10 on improving pain was not stratified by statin type or dose. She said that it is hoped that larger future studies will evaluate levels of pain reduction with coenzyme Q10 in different statins and different doses.

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