Co enzyme Q 10 (CoQ10)

Co enzyme Q 10 (CoQ10)

PEP Topic 
Fatigue
Description 

CoQ10 is a substance found in cell membranes that plays a role in energy production and transport at the cellular level. It has antioxidant properties. Although suggested in the lay literature for multiple conditions, it is not currently approved for the treatment of any condition. CoQ10 was studied in patients with cancer for its effect on fatigue.

Effectiveness Not Established

Research Evidence Summaries

Iwase, S., Kawaguchi, T., Yotsumoto, D., Doi, T., Miyara, K., Odagiri, H., . . . Yamaguchi, T. (2016). Efficacy and safety of an amino acid jelly containing coenzyme Q10 and L-carnitine in controlling fatigue in breast cancer patients receiving chemotherapy: A multi-institutional, randomized, exploratory trial (JORTC-CAM01). Supportive Care in Cancer, 24, 637–646. 

doi: 10.1007/s00520-015-2824-4
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Study Purpose:

To investigate the effectiveness of a dietary supplement amino acid jelly containing coenzyme Q10 and L-carnitine in controlling fatigue in patients with breast cancer

Intervention Characteristics/Basic Study Process:

A dietary supplement containing branched chain amino acids coenzyme Q10 and L-carnitine was given orally once daily for 21 days at a dose of 125 g. Patients in the control group received usual care. Study assessments were conducted on day 1 and day 22, and fatigue was measured on days 8 and 15.

Sample Characteristics:

  • N = 57  
  • MEDIAN AGE = 50 years
  • AGE RANGE = 22–70 years
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: All patients had breast cancer; 89% had recurrence, and 86% had metastases. All were receiving chemotherapy, with varied regimens.

Setting:

  • SITE: Multi-site  
  • SETTING TYPE: Not specified    
  • LOCATION: Japan

Phase of Care and Clinical Applications:

  • PHASE OF CARE: Active antitumor treatment

Study Design:

  • Open-label, multicenter, randomized, controlled trial

Measurement Instruments/Methods:

  • Brief Fatigue Inventory (BFI)
  • Hospital Anxiety and Depression Scale (HADS)
  • European Organization for Research and Treatment of Cancer Core Quality of Life (EORTC QLQ-C30)
  • EORTC QLQ-BR-23

Results:

Fatigue initially increased from baseline to day 8 and then declined in both groups. The mean change in worst level of fatigue was greater with the intervention (p = 0.005). The mean reduction in current level of fatigue was greater with the intervention (p = 0.0009). No differences existed between groups in average feeling of fatigue or anxiety and depression scores.

Conclusions:

The dietary supplement tested here may have some benefit in controlling fatigue among patients with breast cancer during chemotherapy.

Limitations:

  • Small sample (< 100)
  • Risk of bias (no blinding)
  • The study was underpowered.
  • No placebo control
  • Baseline fatigue levels were not reported, so whether baseline fatigue was clinically relevant is unknown.

Nursing Implications:

These findings suggest that a dietary supplement of branched chain amino acids coenzyme Q10 and L-carnitine may be helpful for the management of fatigue. Further research is needed to confirm this potential.

Lesser, G. J., Case, D., Stark, N., Williford, S., Giguere, J., Garino, L. A., . . . Wake Forest University Community Clinical Oncology Program Research Base. (2013). A randomized, double-blind, placebo-controlled study of oral coenzyme Q(10) to relieve self-reported treatment-related fatigue in newly diagnosed patients with breast cancer. Journal of Supportive Oncology, 11, 31–42.

doi: 10.1016/j.suponc.2012.03.003
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Study Purpose:

To determine the effect of ​coenzyme Q10 (CoQ10) on self-reported fatigue, depression, and quality of life.

Intervention Characteristics/Basic Study Process:

Patients were women with breast cancer and planned adjuvant chemotherapy randomized to oral supplements of 300 mg of CoQ10 or placebo, each combined with 300 IU of vitamin E in three daily doses. The intervention began within four days of starting chemotherapy and was continued for 24 weeks. All study assessments were conducted at baseline and 8,16, and 24 weeks. Serum CoQ10 and vitamin E levels were used to measure adherence to the study medications.

Sample Characteristics:

  • The study included 175 patients with breast cancer (all women) who completed eight weeks and 139 patients who completed 24 weeks.  
  • Median age was 51 years (range 28–85).
  • Patients were newly diagnosed with breast cancer.

Setting:

Patients' homes in South Carolina

Phase of Care and Clinical Applications:

Patients were undergoing the active antitumor treatment phase of care.

Study Design:

This was a randomized, placebo-controlled, double-blind trial.

Measurement Instruments/Methods:

The study used multiple instruments with the primary outcome of fatigue:

  • Profile of Mood States-Fatigue (POMS-F)
  • Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F)
  • Linear analogue scale assessment [LASA]-Fatigue.

Results:

No significant differences existed between the CoQ10 and placebo arms at 24 weeks for scores on the outcome instruments measuring fatigue. In addition, no significant differences were found on secondary outcomes, such as quality of life measured by the FACT-Brease Cancer (BC) instrument or the ​Center for Epidemiologic Studies Depression (CESD) Scale measuring depression.

Conclusions:

Supplementation with conventional doses of CoQ10 led to sustained increases in plasma CoQ10 levels but did not result in improved self-reported fatigue or quality of life after 24 weeks of treatment.

Nursing Implications:

The study suggests that no evidence exists that using standard-dose CoQ10 supplementation to target fatigue in newly diagnosed women with breast cancer is effective in ameliorating treatment-related fatigue.

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