WITHDRAWN: Coenzyme Q10 for Parkinson's disease.
Author(s): Liu J, Wang LN, Zhan SY, Xia Y.
Affiliation(s): Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China.
Publication date & source: 2012, Cochrane Database Syst Rev. , 5:CD008150
BACKGROUND: A number of preclinical studies in both in vitro and in vivo models
of Parkinson's disease have demonstrated that coenzyme Q10 can protect the
nigrostriatal dopaminergic system. Some clinical trials have looked at the
neuroprotective effects of coenzyme Q10 in patients with early and midstage
Parkinson's disease.
OBJECTIVES: To assess the evidence from randomized controlled trials on the
efficacy and safety of treatment with coenzyme Q10 compared to placebo in
patients with early and midstage Parkinson's disease.
SEARCH METHODS: We searched the Cochrane Movment Disorders Group Trials Register,
CENTRAL (The Cochrane Library 2009, Issue 4), MEDLINE (January 1966 to March
2011), and EMBASE (January 1985 to March 2011). We handsearched the references
quoted in the identified trials, congress reports from the most important
neurological association and movement disorder societies in Europe and America
(March 2011), checked reference lists of relevant studies and contacted other
researchers.
SELECTION CRITERIA: We included randomized controlled trials (RCTs) that compared
coenzyme Q10 to placebo for patients who suffered early and midstage primary
Parkinson's disease. Studies in which the method of randomization or concealment
were unknown were included. Cross-over studies were excluded.
DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial
quality and extracted data. All disagreements were resolved by consensus between
authors and were explained. We attempted to contact the authors of studies for
further details if any data were missing and to establish the characteristics of
unpublished trials through correspondence with the trial coordinator or principal
investigator. Adverse effects information was collected from the trials.
MAIN RESULTS: Four randomized, double-blind, placebo-controlled trials with a
total of 452 patients met the inclusion criteria and were included in the review.
In overall, there were improvements in activities of daily living (ADL) UPDRS
(WMD -3.12, 95% CI -5.88 to -0.36) and Schwab and England (WMD 4.43, 95% CI 0.05
to 8.81) for coenzyme Q10 at 1200 mg/d for 16 months versus placebo.In safety
outcomes, only the risk ratios (RR) of pharyngitis (RR 1.04, 95% CI 0.18 to 5.89)
and diarrhea (RR 1.39, 95% CI 0.62 to 3.16) are mild elevated between coenzyme
Q10 therapy and placebo and there were no differences in the number of
withdrawals due to adverse effects (RR 0.61, 95% CI 0.23 to 1.62).
AUTHORS' CONCLUSIONS: Coenzyme Q10 therapy with 1200 mg/d for 16 months was well
tolerated by patients with Parkinson's disease. The improvements in ADL UPDRS and
Schwab and England were positive, but it need to be further confirmed by larger
sample. For total and other subscores of UPDRS, the effects of coenzyme Q10
seemed to be less clear.
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