In the dynamic field of clinical nutrition, the continual exploration for effective complementary treatments for chronic ailments is critical. Recent research published in ‘Clinical Nutrition ESPEN’ examines the role of Coenzyme Q10 (CoQ10), a potent antioxidant and anti-inflammatory substance, in the management of rheumatic diseases. This article summarizes the systematic review’s findings and implications for future research and patient care.

The Potential of CoQ10 in Rheumatic Disease Control

Rheumatic diseases, characterized by inflammation and pain, affect millions globally, impairing their quality of life. Therapeutic strategies that can alleviate symptoms and improve patient wellbeing are invaluable. CoQ10 has emerged as a potential player in mitigating the harsh effects experienced by sufferers of rheumatic conditions. In a recent systematic review published in ‘Clinical Nutrition ESPEN’ (DOI: 10.1016/j.clnesp.2023.11.016), researchers scrutinized the efficacy of CoQ10 supplementation in treating such diseases. Their findings suggest that CoQ10 could be a beneficial adjunct therapy for patients with rheumatic diseases, including Rheumatoid Arthritis (RA), Antiphospholipid Syndrome (APS), and Fibromyalgia (FM).

A Closer Look at the Research

The systematic review analysed articles from PubMed/Medline, Embase, Scopus, and Web of Science databases, focusing on studies published between 1966 and April 2023. From the twenty articles included, encompassing 483 patients, the conditions investigated were predominantly FM, RA, and APS.

Researchers, led by Jozélio Freire de Carvalho of the Federal University of Bahia in Salvador, Brazil, and Thelma Skare of the Hospital Evangélico Mackenzie in Curitiba, Brazil, scrutinized the impact of CoQ10 supplementation on these rheumatic conditions. Their key findings included notable improvements in inflammatory markers, disease activity, pain, fatigue, and overall disease impact in RA and FM patients. Meanwhile, patients with APS exhibited enhancements in endothelial function and a clear reduction in prothrombotic and proinflammatory mediators.

The Results

For Rheumatoid Arthritis patients, the addition of CoQ10 resulted in a significant improvement in the disease activity index. Biomarkers indicating inflammation, such as the erythrocyte sedimentation rate, along with cytokine levels, also showed improvement. Furthermore, a decrease in malondialdehyde indicated a lowering of oxidative stress within these patients.

In cases of Antiphospholipid Syndrome, CoQ10 supplementation led to an improvement in endothelial function. This finding is particularly encouraging as endothelial dysfunction is a predictor of vascular events in APS patients. Additionally, the reduction of prothrombotic and proinflammatory markers suggests a decreased risk for thrombotic events, which are a major risk factor in APS.

For Fibromyalgia patients, most studies reported improvements in several crucial areas, including pain reduction, alleviation of fatigue, better sleep quality, a decrease in tender points count, and better mood. These improvements were reflected in the Fibromyalgia Impact Questionnaire scores, suggesting a significant enhancement in life quality.

Tolerability and Side Effects

The review observed that CoQ10 was generally well-tolerated by patients with only minor side effects reported in two studies. This is an important consideration for long-term management of chronic rheumatic diseases, where patient compliance to treatment regimens is essential.

Conclusion and Recommendations

The comprehensive review conducted by the authors underscores the potential of CoQ10 as a complementary treatment for managing rheumatic diseases, specifically Rheumatoid Arthritis and Fibromyalgia. The findings are promising, but the authors encourage further investigations with more extensive samples and inclusion of other rheumatic diseases to firmly establish the role of CoQ10 in clinical practice.

Future investigations should ideally be randomized controlled trials with a larger pool of participants to confirm these benefits and elucidate underlying mechanisms. Such research would provide more definitive evidence for the integration of CoQ10 into treatment protocols for rheumatic diseases.


1. Freire de Carvalho Jozélio J, Skare Thelma T. “Coenzyme Q10 supplementation in rheumatic diseases: A systematic review.” Clinical Nutrition ESPEN, vol. 59, Feb. 2024, pp. 63-69.
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