16 patients with advanced gastric adenocarcinoma with
lovastatin 35 mg/kg/day for 7 consecutive days. All subjects
received 240 mg of CoQ10 daily. Only 2 patients developed
increased CK levels, myalgia, and muscle weakness. The
authors reported that symptoms were successfully managed
with CoQ10 and symptomatic treatment. The dose of
CoQ10 required for this treatment was not specified nor
was a control group without supplementation included.
There are only 2 randomized trials, both in abstract form,
that were designed to evaluate CoQ10 as a treatment for
statin-associated myopathy (45,46). The first treated 41
patients with statin-associated myalgia with either 400 IU
of vitamin E or 100 mg of CoQ10 daily for 30 days.
Preliminary results suggest a significant improvement in
pain scores in patients treated with CoQ10, with 18 of 21
reporting improvement in symptom severity and a reduction
in mean pain scores (6.2 1.7 to 3.1 2.2 at baseline using
a 10-point scale (p 0.001). By comparison, only 3 of 20
patients on vitamin E reported improvement in their symptoms,
and there was no change in this group’s mean pain
score (3.9 2.2 vs. 3.1 2.2, p NS). These results
require confirmation.
A more recent trial (46) randomized 44 dyslipidemic
patients with prior statin-induced myalgia to 12 weeks of
treatment with escalating doses of simvastatin (10 mg/day
to 40 mg/day) and CoQ10 200 mg/day or placebo. Plasma
CoQ10 levels increased with CoQ10 supplementation, but
there were no differences in myalgia scores (p 0.63) or in
statin tolerance between the 2 treatment groups. Specifically,
similar numbers of patients in both groups were able
to tolerate simvastatin 40 mg (p 0.34) and 10 mg (p
0.35) daily.