Promising efficacy of coenzyme Q10 supplementation as adjunctive therapy in juvenile idiopathic arthritis: a randomized-controlled pilot study.
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BACKGROUND: Coenzyme Q10 (CoQ10), a potent antioxidant and anti-inflammatory agent, has shown therapeutic promise in adult autoimmune disorders. However, its role in juvenile idiopathic arthritis (JIA) has not been explored. OBJECTIVE: To evaluate the efficacy and safety of oral CoQ10 in JIA patients. MATERIALS AND METHODS: In this prospective, single-blinded-pilot trial, 58 patients with active JIA were randomized equally to receive either CoQ10 (100 mg/day) or placebo plus standard therapy for 3 months. Clinical outcome was assessed using Juvenile Arthritis Disease Activity Score (JADAS-10). The quality of life (QoL) was evaluated using Childhood Health Assessment Questionnaire (CHAQ). Biochemical markers included tumor necrosis factor-α (TNF-α), malondialdehyde (MDA), and glutathione (GSH). All parameters were assessed at baseline and after 3 months. RESULTS: Fifty-one patients completed the study. The median percent change of JADAS score in the CoQ10 group was -49.1 which was significantly lower than the control group with a median percent change of 2, p < 0.001. Within-group and between groups comparisons showed that the QoL significantly improved in the CoQ10 group compared to the control group (median percent change -60 vs. -33 respectively, p < 0.001). Same positive effects were observed on serum biomarkers whereas median percent changes in the CoQ10 group versus control group were -29.1 vs. -4.3, -44.4 vs. 2, and 12.1 vs. -5.1 for TNF-α, MDA and GSH respectively (all p < 0.01). Minor side-effects were reported during the study. CONCLUSION: CoQ10 significantly improved disease severity, QoL, and inflammatory and oxidative stress markers in JIA patients with an excellent safety profile. UNLABELLED: Clinical-trials.gov identification number: NCT05871086.