Introduction: Coenzyme Q10 is an antioxidant and plays an important role in mitochondrial metabolism.
Statins have been associated with a decrease in Q10 levels because inhibition of cholesterol
synthesis also inhibits Q10 synthesis. Ezetimibe, a cholesterol absorption inhibitor,
has been shown to increase HMG-CoA-reductase activity and cholesterol synthesis. Purpose
of the present study was to evaluate the effects of a 14 day-treatment with either
Eze or Simva alone or Eze plus Simva on the Q10 levels in healthy men.
Material and Methods: This monocenter study was a prospective randomized 3-group trial examining the effects
of Eze (10mg/day), Simva (40mg/day) and their combination (10mg/day Eze plus 40mg/day
Simva) on blood concentrations of Q10 of 72 healthy men (3 groups of 24 each) with
a mean age of 32±9yrs and pre-treatment LDL-C ≤190mg/dl.
Results: The LDL-C concentrations were at baseline 105±23mg/dl in the Eze group, 113±30mg/dl
in the Simva group and 116±35mg/dl in the combination group (p=0.40). They decreased
in all three groups after 14 days of treatment –22±10% in the Eze group, –41±12% in
the Simva group and –60±10% in the combination group; ANOVA p<0.0001). The mean±SD
blood concentration of Q10 at baseline was 0.97±0.28µg/ml in the Eze group, 1.01±0.29µg/ml
in the Simva group and 0.98±0.33µg/ml in the combination group (p=0.89). After 14
days of treatment the Q10 levels remained unchanged in the Eze group (+1±21%, n.s.).
They decreased in the Simva and in the combination group (–16±16% p=0.0003 and –28±12%
p<0.0001, respectively).
Conclusions: Eze has no effect on Q10 blood levels while Simva causes their marked decrease. Co-administration
of Simva and Eze does not ameliorate the Simva-induced decrease in Q10 concentrations
as could be expected from the possible compensatory increase in endogenous cholesterol
synthesis. Routine Q10 supplementation during statin therapy in order to avoid common
side-effects of statins attributed to Q10 deficiency such as exercise intolerance,
myopathy and myoglobinuria should be evaluated.