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Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine-a meta-analysis

S Sazali, S Badrin, M N Norhayati, N S Idris
BMJ Open 2021 11(1):e039358

Bibliography

PubMed
PMID 33402403
PubMed Central
PMC7786797
DOI
10.1136/bmjopen-2020-039358
Funding
Two of the six included trials declared funding from drug manufacturers. A specific funding source for the systematic review itself was not identified in the accessible article record checked.
Competing interests
The review incorporated trials with manufacturer funding; a specific review-author conflict statement was not identified in the accessible abstract checked during this audit.

Study snapshot

DesignSystematic review and meta-analysis
ModelSystematic review and random-effects meta-analysis of randomized controlled trials of CoQ10 prophylaxis in adults with migraine.
Sample6 randomized studies; 371 participants.
InterventionOral CoQ10 versus placebo/control across randomized trials; dose and whether CoQ10 was used alone or with another supplement varied.
Duration
EndpointsMigraine headache severity; Attack duration; Attack frequency; Dose subgroup; CoQ10-alone versus combination subgroup; Risk-of-bias sensitivity analyses

What the study showed, in plain terms

This 2021 meta-analysis pooled six randomized migraine-prophylaxis trials with 371 participants. It found that CoQ10 reduced migraine attack frequency and attack duration, but did not produce a statistically significant reduction in headache severity.

Attack frequency improved by a pooled mean difference of -1.52 (95% CI -2.40 to -0.65; p<0.001; I²=0%), and attack duration improved by -0.19 in the scale used by the contributing trials (95% CI -0.27 to -0.11; p<0.00001; I²=0%).

The evidence base remains small and heterogeneous in dose/intervention design, and two of the six trials disclosed manufacturer funding. The result supports a possible prophylactic effect on frequency/duration, not a blanket claim that CoQ10 improves every migraine outcome.

Key findings

Attack frequency: MD -1.52, 95% CI -2.40 to -0.65, p<0.001; I²=0%, favoring CoQ10.

Attack duration: MD -0.19, 95% CI -0.27 to -0.11, p<0.00001; I²=0%, favoring CoQ10.

Headache severity: no statistically significant pooled reduction.

Six randomized studies/371 participants met eligibility. Cross-over and nonrandomized controlled designs were excluded from the main review eligibility.

Two included trials disclosed manufacturer funding. Subgroup analyses examined dose and CoQ10-alone versus combination supplementation; sensitivity analysis examined sequence generation/allocation-concealment risk of bias.

PROSPERO registration: CRD42019126127.

What this study can and cannot tell us

Only six trials and 371 total participants, so the evidence remains vulnerable to small-study effects and imprecision.

Dose, treatment duration, CoQ10 formulation and whether CoQ10 was administered alone or with another supplement varied across studies.

Two of six included trials had manufacturer funding, adding potential sponsorship bias to a small evidence base.

The pooled benefit was outcome-specific: frequency and duration improved, whereas severity did not reach statistical significance.

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Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology