REPOST: Coenzyme Q10 for Early Parkinson's Disease

October 23, 2002

Subject: Coenzyme Q10 for Early Parkinson's Disease

Date: 10/14/2002

Effects of coenzyme Q10 in early Parkinson disease: Evidence of slowing of

the functional decline

CW Shults, D Oakes, K Kieburtz, et al., and the Parkinson's Study Group

Arch Neurol 2002;59:1541-1550

High-dose Coenzyme Q10 slows the development of disability in early PD

patients, according to this study.

Eighty PD patients not yet on levodopa therapy were randomized to receive

placebo or one of three doses of coenzyme Q10: 300, 600, or 1200 mg/day. All

study medications included 300 IU vitamin E as a lipophilic carrier. The

primary outcome variable was the change in UPDRS total score from the

initial visit to the final visit. The final visit was either 16 months after

entry or the point at which levodopa was needed, whichever came first.

Four patients dropped out or were lost to follow-up. Adverse events were

mild, and were similar among all groups. No clinically significant changes

in laboratory values were seen in any group. Mean changes in UPDRS by group

from baseline to last visit were:

Placebo: +11.99

300 mg: +8.81

600 mg: +10.82

1200 mg: +6.69 (p=0.04 vs. placebo)

The effect was significant in all three domains of the UPDRS, but the

greatest effect was in part II, ADLs. No significant effect was seen on

Hoehn & Yahr score or timed tapping. Treatment did not delay the time until

levodopa was needed, but the authors state that evidence from the DATATOP

study indicated this would be a less informative measure and hence was not

included as a primary variable in the present study.

The authors conclude, " The mechanism(s) through which coenzyme Q10 exerted

its beneficial effect cannot be determined from our clinical trial, but our

data are consistent with an effect on mitochondrial function…To our

knowledge, our study is the first trial to systematically explore the safety

and efficacy of high dosages of coenzyme Q10. Our data suggest that in

treatment of neurological disorders in which evidence of complex I or II

dysfunction are found, such as PD and Huntington disease, dosages much

higher than those previously used may be required. The benefit was greatest

in the group receiving the highest dosage, 1200 mg/d. It is conceivable that

a greater effect could be seen at even higher dosages of coenzyme Q10.

Future studies of coenzyme Q10 in PD and other disorders will need to

explore the effect of dosages of 1200 mg/d and higher.

" In our study, coenzyme Q10 treatment at high dosages was safe and well

tolerated and reduced the worsening of PD, as reflected in the total UPDRS

score. It would be premature to recommend the use of coenzyme Q10 for the

treatment of PD. Our results need to be confirmed in a larger, phase 3

study, and the appropriate dosage and the magnitude of effect need to be

better defined. "

An editorial by Roger Rosenberg accompanies the study.

*** See:

Mitochondrial Therapy for Parkinson Disease

Roger N. Rosenberg, MD

http://archneur.ama-assn.org/issues/v59n10/ffull/ned20014.html

The abstract of this study is available online

*** See:

Effects of Coenzyme Q10 in Early Parkinson Disease

Evidence of Slowing of the Functional Decline

http://archneur.ama-assn.org/issues/v59n10/abs/noc20145.html

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Editor: (rrobinson@...)

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October 23, 2002