Effectiveness of Coenzyme Q10 on echocardiographic parameters of patients with Duchenne muscular dystrophy

Abstract

BackgroundMyocardial damage is a common complication in patients with Duchenne muscular dystrophy (DMD) that occurs due to myocardial replacement by fat and fibrosis. In recent years, efforts have been made toward finding new pharmacological agents with fewer complications which can be used as prophylactic before the symptoms. Coenzyme Q10 plays a central role in production of bioenergy in heart muscle and antioxidant in reperfusion condition of myocardial damaged muscle and leads to membrane stability and prevents cell death.ObjectiveThis study aimed at comparing the Effectiveness of coenzyme Q10 on echocardiographic parameters of pediatric patients with Duchenne muscular dystrophy.MethodsThis randomized clinical trial study (RCT) was carried out on 25 pediatric patients with pre-diagnosed DMD who attended the Children’s Medical Center (CMC), Tehran, Iran from February 2013 to 2015. The patients were randomly divided into two groups. Group-1; (n=12) was treated with coenzyme Q10 for six months and group-2 ;(n=13) received placebo for the same time. The primary aim was to compare the myocardial performance index (MPI), between the two groups at the end of six months. Data were analyzed by SPSS software (ver-16) and using T-Test.ResultsTwenty-five patients under study were divided into two groups of (Q10=12) and (placebo=13). Mean ages were 8.9±1.7 and 8.6±1.4 in Q10 and placebo groups (P=0.66). No significant difference was detected in MPI at all three views of mitral and tricuspid and septum respectively in two groups after the end of treatment (0.41±0.13, and 0.43±0.6; P=0.59), (0.45±0.12, and 0.46±0.1; P=0.05), and (0.45±0.06, and 0.45±0.1; P=0.31).ConclusionAccording to the results obtained from this study, coenzyme Q10 had no significant effect on improving the performance of echocardiographic parameters in patients with DMD.Trial registrationThe trial is registered at the Iranian Clinical Trial Registry (IRCT.ir) with the IRCT identification number IRCT2015070223018N1.FundingThis research has been financially supported by the Research Council of Tehran University of Medical Sciences.

Safety issues and harmful pharmacological interactions of nutritional supplements in Duchenne muscular dystrophy: considerations for Standard of Care and emerging virus outbreaks

“…CoQ 10 is also a potent antioxidant and may counteract the excessive ROS production in dystrophic myofibres. The compound was tested in different clinical trials in DMD patients with encouraging results: CoQ 10 supplementation ameliorated the impaired myocardial function and physical performance [179][180][181], although no significant improvement in echocardiographic parameters was revealed [182]. Interestingly, idebenone, a synthetic analogue of CoQ10 sharing its antioxidant profile, is at an advanced stage of development for treating cardiorespiratory dysfunction of DMD patients [182][183][184].…”

A systematic review of pharmacologic therapies for the cardiomyopathy of Duchenne muscular dystrophy

“…Randomized trials ( n = 10) studied the effects of ACEI or ACEI plus BB ( n = 4), 8,9,16,20 aldosterone inhibitors ( n = 2), 29‐31 and four other novel therapies 26‐28,32 …”

“…Growth hormone administered over 3 months resulted in an increased LV mass, the significance of which is unclear 27 . After 6 months of treatment with coenzyme Q10, LV function did not change 32 . A sildenafil trial was stopped prematurely due to increases in LV end‐systolic volume at 6 months in patients receiving active therapy 28…”

Current Pharmacological Strategies for Duchenne Muscular Dystrophy

“…A Phase 3 clinical study reported that CoQ10 could prevent the loss of respiratory function in DMD patients. The favorable safety and tolerability profiles of CoQ10 make it a potential option to ameliorate the ROS in DMD ( Salehi et al, 2017 ).…”