{"id":"90bcae54-410b-524b-9381-81abd6d273e2","stable_key":"3b5aff9b-4086-5574-bfb4-3ea49ba520d7:coq10-statin-2022-pain-null","predicate":"did_not_reduce","statement":"The 2022 trial found no effect on myalgia; individual changes in muscle CoQ did not correlate with changes in symptom intensity.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"be2b2376-8e0b-56b5-b666-bc2c7fadae09","mechanism_event_label":"A measured muscle pool and the pain outcome must be assessed separately.","subject":{"id":"f1bcf0ac-3578-5afa-97d7-ef3551b657c5","slug":"coq10","display_name":"Coenzyme Q10 / CoQ10 redox system","entity_type_key":"chemical_species"},"object":{"id":"6d822dfd-c22c-594d-9660-a539e8b22759","slug":"statin-muscle-pain","display_name":"Statin-associated muscle pain","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"be2b2376-8e0b-56b5-b666-bc2c7fadae09","stable_key":"3b5aff9b-4086-5574-bfb4-3ea49ba520d7:coq10-statin-2022-pain-null-event","event_type":"observed_intervention","label":"A measured muscle pool and the pain outcome must be assessed separately.","description":"The 2022 trial found no effect on myalgia; individual changes in muscle CoQ did not correlate with changes in symptom intensity.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"f1bcf0ac-3578-5afa-97d7-ef3551b657c5","slug":"coq10","display_name":"Coenzyme Q10 / CoQ10 redox system","entity_type_key":"chemical_species"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"6d822dfd-c22c-594d-9660-a539e8b22759","slug":"statin-muscle-pain","display_name":"Statin-associated muscle pain","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""}]},"contexts":[{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/coq10-research/36139772.abstract.txt\", \"locator\": \"Primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"07baaf957ba2b166fce6e23f157e7d2123c92bea20032628c332c0a40639b992\", \"start_char\": 0, \"end_char\": 1370, \"text_sha256\": \"07baaf957ba2b166fce6e23f157e7d2123c92bea20032628c332c0a40639b992\"}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Randomized placebo-controlled muscle-biopsy supplementation trial","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"CoQ10 400 mg/day for eight weeks","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"One formulation/regimen and a small sample; a failed tissue or clinical response cannot establish universal nonresponse.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Coenzyme Q10 research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"coq10","display_name":"Coenzyme Q10 / CoQ10 redox system","entity_type_key":"chemical_species"}},{"dimension":"organism","value_text":"37 simvastatin-treated adults with or without myalgia","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"A measured muscle pool and the pain outcome must be assessed separately.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[coq10-p36139772] Coenzyme Q10 Supplementation in Statin Treated Patients: A Double-Blinded Randomized Placebo-Controlled Trial. (2022). https://pubmed.ncbi.nlm.nih.gov/36139772/ DOI: 10.3390/antiox11091698","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Muscle CoQ, mitochondrial function and symptoms","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"d55e9ea0-507d-5bf4-a250-a49a36a5161e","evidence_kind":"source_excerpt","locator":"Lines 996-1007","start_line":996,"end_line":1007,"excerpt":"### coq10-statin-2022-pain-null\nThe 2022 trial found no effect on myalgia; individual changes in muscle CoQ did not correlate with changes in symptom intensity.\nCondition category: normal\nnutrient_topic: Coenzyme Q10 research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: A measured muscle pool and the pain outcome must be assessed separately.\norganism: 37 simvastatin-treated adults with or without myalgia\ntissue_or_cell_type: Muscle CoQ, mitochondrial function and symptoms\nexperimental_model: Randomized placebo-controlled muscle-biopsy supplementation trial\nlimitations: One formulation/regimen and a small sample; a failed tissue or clinical response cannot establish universal nonresponse.\nexposure: CoQ10 400 mg/day for eight weeks\nevidence_span: {\"source_cache\": \"artifacts/coq10-research/36139772.abstract.txt\", \"locator\": \"Primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"07baaf957ba2b166fce6e23f157e7d2123c92bea20032628c332c0a40639b992\", \"start_char\": 0, \"end_char\": 1370, \"text_sha256\": \"07baaf957ba2b166fce6e23f157e7d2123c92bea20032628c332c0a40639b992\"}\n[coq10-p36139772] Coenzyme Q10 Supplementation in Statin Treated Patients: A Double-Blinded Randomized Placebo-Controlled Trial. (2022). https://pubmed.ncbi.nlm.nih.gov/36139772/ DOI: 10.3390/antiox11091698","model_system":"Randomized placebo-controlled muscle-biopsy supplementation trial","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [coq10-p36139772] Coenzyme Q10 Supplementation in Statin Treated Patients: A Double-Blinded Randomized Placebo-Controlled Trial. (2022). https://pubmed.ncbi.nlm.nih.gov/36139772/ DOI: 10.3390/antiox11091698","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"fc6c2f3b-14a3-59de-848e-ca1c02fee1df","stable_key":"import-3b5aff9b-4086-5574-bfb4-3ea49ba520d7","title":"Coenzyme Q10: biosynthesis, electron transfer, antioxidant recycling and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"053f9a6f6c17321fa9fd271486d7f20a86a49b237424108de7dc8663372e73bf","revision_id":"028900ce-8ca4-5d13-8c86-6e327c071e64","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[{"id":"3f5b290b-f0aa-567e-88e9-ebb712ddd2b3","title":"Statin-associated muscle pain: improvement in one trial, absent in others","kind":"contradiction","status":"open","why":"The 2014 study found pain relief, whereas the 2015 trial found no benefit after symptoms were confirmed with blinded simvastatin/placebo exposure. A 2022 trial also found no pain benefit or increase in muscle CoQ. These challenge a general claim of CoQ efficacy for statin-associated muscle pain; selection, formulation, dose and duration differed.","resolution":"Preserve all results. Confirmation of drug-related symptoms, placebo response, formulation, tissue delivery and duration are possible contributors, not proven explanations. Raised serum CoQ does not demonstrate correction of muscle mitochondrial dysfunction.","created_at":"2026-09-17 21:53:19","record_type":"conflict","display_label":"Recorded conflict","record_url":"/conflicts/3f5b290b-f0aa-567e-88e9-ebb712ddd2b3","sides":[{"conflict_id":"3f5b290b-f0aa-567e-88e9-ebb712ddd2b3","ordinal":0,"label":"One trial found less muscle pain with added CoQ.","revision_id":"028900ce-8ca4-5d13-8c86-6e327c071e64","start_line":1152,"end_line":1163,"quote":"### coq10-statin-pain-positive\nPain severity and interference improved relative to placebo after 30 days of CoQ in the 50-patient study.\nCondition category: normal\nnutrient_topic: Coenzyme Q10 research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: One trial found less muscle pain with added CoQ.\norganism: 50 statin-treated patients reporting mild-to-moderate muscle symptoms\ntissue_or_cell_type: Brief Pain Inventory scores\nexperimental_model: Randomized placebo-controlled study\nlimitations: Small short study; symptoms were not confirmed by a blinded statin-placebo lead-in as in the later trial.\nexposure: CoQ10 50 mg twice daily for 30 days\nevidence_span: {\"source_cache\": \"artifacts/coq10-research/25375075.abstract.txt\", \"locator\": \"Primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"c1b3bae22ef80093dd226d2bebbc1791ac08e3952c694f801a72f308fd7258e4\", \"start_char\": 0, \"end_char\": 1622, \"text_sha256\": \"c1b3bae22ef80093dd226d2bebbc1791ac08e3952c694f801a72f308fd7258e4\"}\n[coq10-p25375075] Coenzyme Q10 supplementation decreases statin-related mild-to-moderate muscle symptoms: a randomized clinical study. (2014). https://pubmed.ncbi.nlm.nih.gov/25375075/ DOI: 10.12659/msm.890777","source_key":"import-3b5aff9b-4086-5574-bfb4-3ea49ba520d7","source_title":"Coenzyme Q10: biosynthesis, electron transfer, antioxidant recycling and nutrient interactions (2026-09-17)","claim_ids":["0262bf19-b9aa-5957-8535-a687b0db0b83"]},{"conflict_id":"3f5b290b-f0aa-567e-88e9-ebb712ddd2b3","ordinal":1,"label":"A more strictly selected trial did not reproduce the pain benefit.","revision_id":"028900ce-8ca4-5d13-8c86-6e327c071e64","start_line":1165,"end_line":1176,"quote":"### coq10-statin-pain-null\nUbiquinol did not reduce pain severity or interference versus placebo in confirmed simvastatin myalgia.\nCondition category: normal\nnutrient_topic: Coenzyme Q10 research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: A more strictly selected trial did not reproduce the pain benefit.\norganism: 41 subjects with confirmed simvastatin myalgia\ntissue_or_cell_type: Pain, muscle performance and serum CoQ\nexperimental_model: Randomized double-blind trial after blinded symptom confirmation\nlimitations: Small confirmed-myalgia sample; null outcome is not proof that every other regimen is ineffective.\nexposure: 600 mg/day ubiquinol with simvastatin 20 mg/day for eight weeks\nevidence_span: {\"source_cache\": \"artifacts/coq10-research/25545331.abstract.txt\", \"locator\": \"Primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"2aad217d0053cae8ea41f5be8ee7e0be0fa83f83d779f34e30fabe2a0b29c837\", \"start_char\": 0, \"end_char\": 1976, \"text_sha256\": \"2aad217d0053cae8ea41f5be8ee7e0be0fa83f83d779f34e30fabe2a0b29c837\"}\n[coq10-p25545331] A randomized trial of coenzyme Q10 in patients with confirmed statin myopathy. (2015). https://pubmed.ncbi.nlm.nih.gov/25545331/ DOI: 10.1016/j.atherosclerosis.2014.12.016","source_key":"import-3b5aff9b-4086-5574-bfb4-3ea49ba520d7","source_title":"Coenzyme Q10: biosynthesis, electron transfer, antioxidant recycling and nutrient interactions (2026-09-17)","claim_ids":["238b5cc2-4a35-52d7-bf42-94007b40d7c4"]},{"conflict_id":"3f5b290b-f0aa-567e-88e9-ebb712ddd2b3","ordinal":2,"label":"A larger blood pool did not guarantee a functional response.","revision_id":"028900ce-8ca4-5d13-8c86-6e327c071e64","start_line":1178,"end_line":1189,"quote":"### coq10-statin-plasma-not-function\nSerum CoQ increased from 1.3 to 5.2 micrograms/mL with ubiquinol, without improved muscle strength or aerobic performance.\nCondition category: normal\nnutrient_topic: Coenzyme Q10 research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: A larger blood pool did not guarantee a functional response.\norganism: 41 subjects with confirmed simvastatin myalgia\ntissue_or_cell_type: Pain, muscle performance and serum CoQ\nexperimental_model: Randomized double-blind trial after blinded symptom confirmation\nlimitations: Small confirmed-myalgia sample; null outcome is not proof that every other regimen is ineffective.\nexposure: 600 mg/day ubiquinol with simvastatin 20 mg/day for eight weeks\nevidence_span: {\"source_cache\": \"artifacts/coq10-research/25545331.abstract.txt\", \"locator\": \"Primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"2aad217d0053cae8ea41f5be8ee7e0be0fa83f83d779f34e30fabe2a0b29c837\", \"start_char\": 0, \"end_char\": 1976, \"text_sha256\": \"2aad217d0053cae8ea41f5be8ee7e0be0fa83f83d779f34e30fabe2a0b29c837\"}\n[coq10-p25545331] A randomized trial of coenzyme Q10 in patients with confirmed statin myopathy. (2015). https://pubmed.ncbi.nlm.nih.gov/25545331/ DOI: 10.1016/j.atherosclerosis.2014.12.016","source_key":"import-3b5aff9b-4086-5574-bfb4-3ea49ba520d7","source_title":"Coenzyme Q10: biosynthesis, electron transfer, antioxidant recycling and nutrient interactions (2026-09-17)","claim_ids":["6b49e52a-fdc5-52bd-84a5-132bf4fcba8d"]},{"conflict_id":"3f5b290b-f0aa-567e-88e9-ebb712ddd2b3","ordinal":3,"label":"A measured muscle pool and the pain outcome must be assessed separately.","revision_id":"028900ce-8ca4-5d13-8c86-6e327c071e64","start_line":996,"end_line":1007,"quote":"### coq10-statin-2022-pain-null\nThe 2022 trial found no effect on myalgia; individual changes in muscle CoQ did not correlate with changes in symptom intensity.\nCondition category: normal\nnutrient_topic: Coenzyme Q10 research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: A measured muscle pool and the pain outcome must be assessed separately.\norganism: 37 simvastatin-treated adults with or without myalgia\ntissue_or_cell_type: Muscle CoQ, mitochondrial function and symptoms\nexperimental_model: Randomized placebo-controlled muscle-biopsy supplementation trial\nlimitations: One formulation/regimen and a small sample; a failed tissue or clinical response cannot establish universal nonresponse.\nexposure: CoQ10 400 mg/day for eight weeks\nevidence_span: {\"source_cache\": \"artifacts/coq10-research/36139772.abstract.txt\", \"locator\": \"Primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"07baaf957ba2b166fce6e23f157e7d2123c92bea20032628c332c0a40639b992\", \"start_char\": 0, \"end_char\": 1370, \"text_sha256\": \"07baaf957ba2b166fce6e23f157e7d2123c92bea20032628c332c0a40639b992\"}\n[coq10-p36139772] Coenzyme Q10 Supplementation in Statin Treated Patients: A Double-Blinded Randomized Placebo-Controlled Trial. (2022). https://pubmed.ncbi.nlm.nih.gov/36139772/ DOI: 10.3390/antiox11091698","source_key":"import-3b5aff9b-4086-5574-bfb4-3ea49ba520d7","source_title":"Coenzyme Q10: biosynthesis, electron transfer, antioxidant recycling and nutrient interactions (2026-09-17)","claim_ids":["90bcae54-410b-524b-9381-81abd6d273e2"]},{"conflict_id":"3f5b290b-f0aa-567e-88e9-ebb712ddd2b3","ordinal":4,"label":"Taking more did not ensure delivery or functional change in the sampled muscle.","revision_id":"028900ce-8ca4-5d13-8c86-6e327c071e64","start_line":983,"end_line":994,"quote":"### coq10-statin-muscle-repletion-null\nCoQ supplementation did not increase muscle CoQ or alter measured mitochondrial respiratory function, content or reactive-oxygen-species production.\nCondition category: normal\nnutrient_topic: Coenzyme Q10 research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: Taking more did not ensure delivery or functional change in the sampled muscle.\norganism: 37 simvastatin-treated adults with or without myalgia\ntissue_or_cell_type: Muscle CoQ, mitochondrial function and symptoms\nexperimental_model: Randomized placebo-controlled muscle-biopsy supplementation trial\nlimitations: One formulation/regimen and a small sample; a failed tissue or clinical response cannot establish universal nonresponse.\nexposure: CoQ10 400 mg/day for eight weeks\nevidence_span: {\"source_cache\": \"artifacts/coq10-research/36139772.abstract.txt\", \"locator\": \"Primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"07baaf957ba2b166fce6e23f157e7d2123c92bea20032628c332c0a40639b992\", \"start_char\": 0, \"end_char\": 1370, \"text_sha256\": \"07baaf957ba2b166fce6e23f157e7d2123c92bea20032628c332c0a40639b992\"}\n[coq10-p36139772] Coenzyme Q10 Supplementation in Statin Treated Patients: A Double-Blinded Randomized Placebo-Controlled Trial. (2022). https://pubmed.ncbi.nlm.nih.gov/36139772/ DOI: 10.3390/antiox11091698","source_key":"import-3b5aff9b-4086-5574-bfb4-3ea49ba520d7","source_title":"Coenzyme Q10: biosynthesis, electron transfer, antioxidant recycling and nutrient interactions (2026-09-17)","claim_ids":["3570837a-6b65-58f0-8d1b-bb28644e714f"]}]}],"corrections":[],"research":null}