Statin therapy and plasma coenzyme Q10 concentrations—A systematic review and meta-analysis of placebo-controlled trials

Banach, Maciej; Şerban, Corina; Ursoniu, Sorin; Rysz, Jacek; Muntner, Paul; Tóth, Peter P.; Jones, Steven R.; Rizzo, Manfredi; Glasser, Stephen P.; Watts, Gerald F.; Blumenthal, Roger S.; Lip, Gregory Y.H.; Mikhailidis, Dimitri P.; Sahebkar, Amirhossein

doi:10.1016/j.phrs.2015.07.008

Cited by 156 publications

(71 citation statements)

References 48 publications

(52 reference statements)

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“…One such by-product is co enzyme Q 10 , which is essential for mitochondrial electron transfer function; its depletion by statins contributes to wellknown complications, including myopathy and liver injury 110 . Clinical trials have demonstrated that plasma levels of coenzyme Q 10 markedly drop below the normal range upon initiation of statin therapy 111 . Use of statins in patients with normal or low levels of cholesterol can, in my opinion, only cause harm and no benefit.…”

Section: Treatment Strategies Statinsmentioning

confidence: 99%

HDL abnormalities in nephrotic syndrome and chronic kidney disease

2015

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| Normal HDL activity confers cardiovascular and overall protection by mediating reverse cholesterol transport and through its potent anti-inflammatory, antioxidant, and antithrombotic functions. Serum lipid profile, as well as various aspects of HDL metabolism, structure, and function can be profoundly altered in patients with nephrotic range proteinuria or chronic kidney disease (CKD). These abnormalities can, in turn, contribute to the progression of cardiovascular complications and various other comorbidities, such as foam cell formation, atherosclerosis, and/or glomerulosclerosis, in affected patients. The presence and severity of proteinuria and renal insufficiency, as well as dietary and drug regimens, pre-existing genetic disorders of lipid metabolism, and renal replacement therapies (including haemodialysis, peritoneal dialysis, and renal transplantation) determine the natural history of lipid disorders in patients with kidney disease. Despite the adverse effects associated with dysregulated reverse cholesterol transport and advances in our understanding of the underlying mechanisms, safe and effective therapeutic interventions are currently lacking. This Review provides an overview of HDL metabolism under normal conditions, and discusses the features, mechanisms, and consequences of HDL abnormalities in patients with nephrotic syndrome or advanced CKD.

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Section: Treatment Strategies Statinsmentioning

confidence: 99%

HDL abnormalities in nephrotic syndrome and chronic kidney disease

2015

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“…In the last years, various systematic reviews and clinical trials have been published showed that persons taking statins develop deficient levels of Coq10 and supplementation of Coq10 decreases the negative side effects of statins [14][15][16]. Correspondingly, it is crucial that clinicians understand that statins block the HMG-CoA reductase, thus reducing the levels of Coq10 producing consequences beyond musclerelated adverse events.…”

Section: Studies With the Coq10mentioning

confidence: 99%

“…Six randomized controlled trials and nine observational studies reported that statins reduce plasma and serum Coq10 levels by 16-54% and Coq10 deficiency was identified as a strong mortality predictor in chronic heart failure [14][15][16][17][18]. Also, statins may unmask presymptomatic neuromuscular disorders, thus, elevated serum creatine kinase (CK) levels and adverse muscle events should be monitoring after discontinuation of statins [19].…”

Section: Studies With the Coq10mentioning

confidence: 99%

The Role of Coenzyme Q10 Supplementation with Statin Drug Use and Chronic Diseases

Peres¹,

Foss²,

Pereira³

2017

J Infect Dis Preve Med

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Patients with chronic diseases exhibit a deficiency of Coenzyme Q10 (Coq10). Also, there is no doubt lowering cholesterol medication, statin drugs will "reduce the natural levels of CoQ10 in the body" Known to have antioxidant effects, Coq10 is essential for the proper functioning of adenine triphosphate (ATP) energy production in the cells. There is medical literature with positive recommendations for Coq10 supplementation with statin drugs. Unfortunately, because of controversial studies cited in the literature, there exists misinformation about the benefits of Coq10 supplementation in patients taking statins. Thus, the objective this mini-review is to discuss the beneficial role Coq10 supplementation provided to individuals taking statins and to encouraging doctors and health professionals to prescribe Coq10. Some of the negative feedback stems from the low bioavailability of oral Coq10 supplements. However, newer sublingual Coq10 supplementation formulas are much more absorbable. Additionally, solubilized CoQ10 in oil formulations show enhanced bioavailability. Coq10 protects the mitochondria and low levels of Coq10 produce mitochondrial dysfunction, reducing adenine triphosphate production. Various chronic diseases respond positively to Coq10 supplementation. Systematic reviews and clinical trials show persons taking statin medication have deficient levels of Coq10 and Coq10 supplementation decreases the negative side effects of statins. Unfortunately, many clinicians do not understand that the statin drugs block the rate-controlling enzyme of the mevalonate pathway, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMG-CoA reductase) whose detrimental consequences are broader than muscle-related adverse events. Providing significant improvement in endothelial function, Coq10 supplementation has been shown, also, to be efficacious in persons with heart failure. We argue in our medical communities; a perceptual shift is urgently needed, providing a positive approach to Coq10 supplementation with statin drug users and chronic disease patients.

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“…Statin depletion of coenzyme Q10 (CoQ10) has been considered a plausible explanation for the development of SAMS (85,86). Accordingly, supplementation of CoQ10 has been theorized to improve or reduce myalgias.…”

Section: -Complemenary and Alternative Medicinementioning

confidence: 99%

Expert opinion: the therapeutic challenges faced by statin intolerance

Patel

Martin²,

Banach

2016

Expert Opinion on Pharmacotherapy

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When initiating statin therapy, attention to risk factors for statin intolerance is strongly recommended. Most patients will tolerate some degree of statin therapy; thus statin re-challenge is advisable. If alternative dosing regimens are not tolerated, non-statin medications are acceptable alternatives. To limit errors in the diagnosis of statin intolerance, improvements in clinician-patient communication about the side effects and benefits of statins should be attempted.

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Statin therapy and plasma coenzyme Q10 concentrations—A systematic review and meta-analysis of placebo-controlled trials

Cited by 156 publications

References 48 publications

HDL abnormalities in nephrotic syndrome and chronic kidney disease

HDL abnormalities in nephrotic syndrome and chronic kidney disease

The Role of Coenzyme Q10 Supplementation with Statin Drug Use and Chronic Diseases

Expert opinion: the therapeutic challenges faced by statin intolerance

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