Efficacy and Safety of CoenzymeQ10 for Parkinson’s Disease: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 WANGQing , LUOCan , YUANZhen-hua ,  LUZu-neng

Department of Neurology, Renmin Hospital of Wuhan University, Wuhan 430060, China;

Corresponding author：

LUZu-neng, Email: lzn196480@126.com

Keywords：

Parkinson’s disease; CoenzymeQ10; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20160109

Video：

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Objective To systematically review the efficacy and safety of CoenzymeQ10 for Parkinson’s disease. Methods Databases including PubMed, The Cochrane Library (Issue 1, 2015), EMbase, CBM, CNKI, WanFang Data and VIP were searched from inception to August 2015, to collect randomized controlled trials (RCTs) about CoenzymeQ10 for Parkinson’s disease. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. Results A total of 5 RCTs involving 981 patients were included. The results of meta-analysis showed that, a) As for recently effectiveness, CoenzymeQ10 2 400 mg group was superior to the placebo group in total UPDRS score change (MD=1.09, 95%CI 0.94 to 1.24, P < 0.000 01), UPDRS-I score change (MD=0.19, 95%CI 0.17 to 0.21, P < 0.000 01), UPDRS-II score change (MD=0.27, 95%CI 0.21 to 0.32, P < 0.000 01), UPDRS-III score change (MD=0.65, 95%CI 0.54 to 0.76, P < 0.000 01), Hoehn & Yahr score change (MD=0.05, 95%CI 0.04 to 0.06, P < 0.000 01), and Schwab England score change (MD= –0.87, 95%CI –1.02 to –0.72, P < 0.000 01). b) As for long-term effectiveness, there were no differences between two groups, except that the UPDRS-II score change of CoenzymeQ10 1 200 mg group was superior to the placebo group. c) As for adverse reactions, there were no statistical differences between two groups except that the incidence of cholesterol of the CoenzymeQ10 600 mg group and incidence of diarrhea of the CoenzymeQ10 2 400 mg group were lower than that of the placebo group. Conclusion Current evidence shows that, the dosage of 2 400 mg/d CoenzymeQ10 is effective and safe for early Parkinson’s disease. Due to the limited quality and quantity of included studies, more higher quality studies are needed to verify the above conclusion.

Citation： WANGQing, LUOCan, YUANZhen-hua, LUZu-neng. Efficacy and Safety of CoenzymeQ10 for Parkinson’s Disease: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(6): 706-711. doi: 10.7507/1672-2531.20160109 Copy

1.	Salama M, Yuan TF, Machado S, et al. Co-enzyme Q10 to treat neurological disorders: basic mechanisms, clinical outcomes, and future research direction. CNS Neurol Disord Drug Targets, 2013, 12(5): 641-664.
2.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated Mach 2011]. The Cochrane Collaboration, 2011. Available at: www.cochrane handbook.org.
3.	Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol, 2002, 59(10): 1541-1550.
4.	Müller T, Büttner T, Gholipour AF, et al. Coenzyme Q10 supplementation provides mild symptomatic benefit in patients with Parkinson's disease. Neurosci Lett, 2003, 341(3): 201-204.
5.	NINDS NET-PD Investigators. A randomized clinical trial of coenzyme Q10 and GPI-1485 in early Parkinson disease. Neurology, 2007, 68(1): 20-28.
6.	Storch A, Jost WH, Vieregge P, Randomized, double-blind, placebo-controlled trial on symptomatic effects of coenzyme Q(10) in Parkinson disease. Arch Neurol, 2007, 64(7): 938-944.
7.	Parkinson Study Group QE3 Investigators. A randomized clinical trial of high-dosage coenzyme Q10 in early Parkinson disease: no evidence of benefit. JAMA Neurol, 2014, 71(5): 543-552.
8.	Schapira AH, Cooper JM, Dexter D, et al. Mitochondrial complex I deficiency in Parkinson's disease. Lancet, 1989, 1(8649): 1269.
9.	Jenner P. Presymptomatic detection of Parkinson's disease. J Neural Transm Suppl, 1993, 40: 23-36.
10.	Shults CW, Barrett JM, Fontaine D. alpha-synuclein from platelets is not phosphorylated at serine 129 in Parkinson's disease and multiple system atrophy. Neurosci Lett, 2006, 405(3): 223-225.
11.	Matthews RT, Yang L, Browne S, et al. Coenzyme Q10 administration increases brain mitochondrial concentrations and exerts neuroprotective effects. Proc Natl Acad Sci USA, 1998, 95(15): 8892-8897.
12.	Snow BJ, Rolfe FL, Lockhart MM, et al. A double-blind, placebo-controlled study to assess the mitochondria-targeted antioxidant MitoQ as a disease-modifying therapy in Parkinson's disease. Mov Disord, 2010, 25(11): 1670-1674.
13.	Murphy MP, Smith RA. Targeting antioxidants to mitochondria by conjugation to lipophilic cations. Annu Rev Pharmacol Toxicol, 2007, 47: 629-656.
14.	Kelso GF, Porteous CM, Coulter CV, et al. Selective targeting of a redox-active ubiquinone to mitochondria within cells: antioxidant and antiapoptotic properties. J Biol Chem, 2001, 276(7): 4588-4596.
15.	Smith RA, Porteous CM, Gane AM, et al. Delivery of bioactive molecules to mitochondria in vivo. Proc Natl Acad Sci USA, 2003, 100(9): 5407-5412.
16.	Adlam VJ, Harrison JC, Porteous CM, et al. Targeting an antioxidant to mitochondria decreases cardiac ischemia-reperfusion injury. Faseb J, 2005, 19(9): 1088-1095.
17.	Esplugues JV, Rocha M, Nunez C, et al. Complex I dysfunction and tolerance to nitroglycerin: an approach based on mitochondrial-targeted antioxidants. Circ Res, 2006, 99(10): 1067-1075.
18.	Neuzil J, Widen C, Gellert N, et al. Mitochondria transmit apoptosis signalling in cardiomyocyte-like cells and isolated hearts exposed to experimental ischemia-reperfusion injury. Redox Rep, 2007, 12(3): 148-162.
19.	Chandran K, Aggarwa lD, Migrino RQ, et al. Doxorubic ininactivates myocardial cytochrome c oxidase in rats:cardio protection by Mito-Q. Biophys J, 2009, 96(4): 1388-1398.

1. Salama M, Yuan TF, Machado S, et al. Co-enzyme Q10 to treat neurological disorders: basic mechanisms, clinical outcomes, and future research direction. CNS Neurol Disord Drug Targets, 2013, 12(5): 641-664.
2. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated Mach 2011]. The Cochrane Collaboration, 2011. Available at: www.cochrane handbook.org.
3. Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol, 2002, 59(10): 1541-1550.
4. Müller T, Büttner T, Gholipour AF, et al. Coenzyme Q10 supplementation provides mild symptomatic benefit in patients with Parkinson's disease. Neurosci Lett, 2003, 341(3): 201-204.
5. NINDS NET-PD Investigators. A randomized clinical trial of coenzyme Q10 and GPI-1485 in early Parkinson disease. Neurology, 2007, 68(1): 20-28.
6. Storch A, Jost WH, Vieregge P, Randomized, double-blind, placebo-controlled trial on symptomatic effects of coenzyme Q(10) in Parkinson disease. Arch Neurol, 2007, 64(7): 938-944.
7. Parkinson Study Group QE3 Investigators. A randomized clinical trial of high-dosage coenzyme Q10 in early Parkinson disease: no evidence of benefit. JAMA Neurol, 2014, 71(5): 543-552.
8. Schapira AH, Cooper JM, Dexter D, et al. Mitochondrial complex I deficiency in Parkinson's disease. Lancet, 1989, 1(8649): 1269.
9. Jenner P. Presymptomatic detection of Parkinson's disease. J Neural Transm Suppl, 1993, 40: 23-36.
10. Shults CW, Barrett JM, Fontaine D. alpha-synuclein from platelets is not phosphorylated at serine 129 in Parkinson's disease and multiple system atrophy. Neurosci Lett, 2006, 405(3): 223-225.
11. Matthews RT, Yang L, Browne S, et al. Coenzyme Q10 administration increases brain mitochondrial concentrations and exerts neuroprotective effects. Proc Natl Acad Sci USA, 1998, 95(15): 8892-8897.
12. Snow BJ, Rolfe FL, Lockhart MM, et al. A double-blind, placebo-controlled study to assess the mitochondria-targeted antioxidant MitoQ as a disease-modifying therapy in Parkinson's disease. Mov Disord, 2010, 25(11): 1670-1674.
13. Murphy MP, Smith RA. Targeting antioxidants to mitochondria by conjugation to lipophilic cations. Annu Rev Pharmacol Toxicol, 2007, 47: 629-656.
14. Kelso GF, Porteous CM, Coulter CV, et al. Selective targeting of a redox-active ubiquinone to mitochondria within cells: antioxidant and antiapoptotic properties. J Biol Chem, 2001, 276(7): 4588-4596.
15. Smith RA, Porteous CM, Gane AM, et al. Delivery of bioactive molecules to mitochondria in vivo. Proc Natl Acad Sci USA, 2003, 100(9): 5407-5412.
16. Adlam VJ, Harrison JC, Porteous CM, et al. Targeting an antioxidant to mitochondria decreases cardiac ischemia-reperfusion injury. Faseb J, 2005, 19(9): 1088-1095.
17. Esplugues JV, Rocha M, Nunez C, et al. Complex I dysfunction and tolerance to nitroglycerin: an approach based on mitochondrial-targeted antioxidants. Circ Res, 2006, 99(10): 1067-1075.
18. Neuzil J, Widen C, Gellert N, et al. Mitochondria transmit apoptosis signalling in cardiomyocyte-like cells and isolated hearts exposed to experimental ischemia-reperfusion injury. Redox Rep, 2007, 12(3): 148-162.
19. Chandran K, Aggarwa lD, Migrino RQ, et al. Doxorubic ininactivates myocardial cytochrome c oxidase in rats:cardio protection by Mito-Q. Biophys J, 2009, 96(4): 1388-1398.

Chinese Journal of Evidence-Based Medicine

Efficacy and Safety of CoenzymeQ10 for Parkinson’s Disease: A Meta-analysis

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