Abstract 11627: Coenzyme Q10 Does Not Reduce Muscle Pain in Patients With Confirmed Statin Myalgia
Background: Coenzyme Q10 (CoQ10) supplementation is the most popular therapy for statin myalgia despite limited evidence for its efficacy. We examined the effect of CoQ10 on simvastatin (SIMVA) -associated muscle pain, and strength and aerobic performance in patients with confirmed statin myalgia.
Methods: Statin myalgia was confirmed in 120 patients with prior statin complaints using an 8-week randomized, double-blind crossover lead-in trial of SIMVA 20 mg/d and placebo. Forty one subjects developed muscle pain with SIMVA but not with placebo and were randomized to SIMVA 20 mg/d combined with CoQ10 (600 mg/d ubiquinol) or placebo for 8 weeks. Of the 41 subjects, 24 then crossed over to the alternative treatment (CoQ10 or placebo). Muscle pain (Brief Pain Inventory [BPI]), time to pain onset, isometric and isokinetic arm and leg muscle strength, and maximal oxygen uptake, (VO2max) were measured before and after each treatment.
Results: CoQ10 blood levels increased from 1.3±0.4 to 5.2±2.3 mcg/mL with SIMVA and CoQ10, but did not increase with SIMVA and placebo (1.3±0.3 to 0.8±0.2) (p < 0.05 for comparison). BPI pain severity and interference scores increased with statin therapy (both p < 0.01), irrespective of CoQ10 assignment (p = 0.53 and 0.56 for comparison), and there was no effect of CoQ10 on muscle strength or VO2max (all p >0.10). Marginally more subjects reported pain with CoQ10 treatment (14 of 20 vs 7 of 18; p = 0.05), and there was no difference in time to pain onset in the CoQ10 (3.0±2.0 weeks) vs. placebo (2.4±2.1 wks) groups (p = 0.55). A similar lack of CoQ10 effect was observed in the 24 cross-over subjects.
Conclusions: CoQ10 supplementation does not reduce muscle pain in patients with statin myalgia.
Trial Registration: NCT01140308
Author Disclosures: B. Taylor: Consultant/Advisory Board; Modest; Amgen Pharmaceutical Safety Monitoring Board. L. Lorson: None. C. White: None. P.D. Thompson: Research Grant; Modest; Genomas, Roche, Sanolfi, Regeneron, Esperion, Amarin and Pfizer. Honoraria; Modest; Merck, Astra Zenica, Kowa, and Amarin. Expert Witness; Modest; has provided expert legal testimony on exercise-related cardiac events and statin myopathy. Ownership Interest; Modest; Abbvie, Abbott Labs, General Electric , J&J. Consultant/Advisory Board; Modest; Amgen, Regeneron, Merck, Genomas, Runners World, Sanolfi, Esperion, and Amarin.
- © 2014 by American Heart Association, Inc.