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A promising new study found that Coenzyme Q10 may
slow the progression of Parkinson's disease. This is potentially
an incredible breakthrough because although existing treatments
may ease symptoms of the degenerative brain disorder, they are not
believed to affect the underlying disease process. This new study
found evidence that CoQ10 may actually help stop the nerve
cell death that characterizes Parkinson's.
Because this information could be so important to
so many people, we have reproduced the complete text of this announcement
from the National Institute of Health / National Institute of Neurological
Disorders and Stroke below.
At the bottom of this page, a link is also included
so you can go to this U.S. Government web site yourself
Study Suggests Coenzyme Q10 Slows Functional
Decline in Parkinson's Disease
Released: Monday, October 14, 2002
Results of the first placebo-controlled, multicenter
clinical trial of the compound coenzyme Q10 suggest that it can
slow disease progression in patients with early-stage Parkinson's
disease (PD). While the results must be confirmed in a larger study,
they provide hope that this compound may ultimately provide a new
way of treating PD. The phase II study, led by Clifford Shults,
M.D., of the University of California, San Diego (UCSD) School of
Medicine, looked at a total of 80 PD patients at 10 centers across
the country to determine if coenzyme Q10 is safe and if it can slow
the rate of functional decline. The study was funded by the National
Institute of Neurological Disorders and Stroke (NINDS) and appears
in the October 15, 2002, issue of the Archives of Neurology.1
"This trial suggested that coenzyme Q10
can slow the rate of deterioration in Parkinson's disease,"
says Dr. Shults. "However, before the compound is used
widely, the results need to be confirmed in a larger group of patients."
PD is a chronic, progressive neurological disease
that affects about 500,000 people in the United States. It results
from the loss of brain cells that produce the neurotransmitter dopamine
and causes tremor, stiffness of the limbs and trunk, impaired balance
and coordination, and slowing of movements. Patients also sometimes
develop other symptoms, including difficulty swallowing, disturbed
sleep, and emotional problems. PD usually affects people over the
age of 50, but it can affect younger people as well. While levodopa
and other drugs can ease the symptoms of PD, none of the current
treatments has been shown to slow the course of the disease.
The investigators believe coenzyme Q10 works
by improving the function of mitochondria, the "powerhouses"
that produce energy in cells. Coenzyme Q10 is an important link
in the chain of chemical reactions that produces this energy. It
also is a potent antioxidant - a chemical that "mops up"
potentially harmful chemicals generated during normal metabolism.
Previous studies carried out by Dr. Shults, Richard
Haas, M.D., of UCSD and Flint Beal, M.D., of Cornell University
have shown that coenzyme Q10 levels in mitochondria from
PD patients are reduced and that mitochondrial function in these
patients is impaired. Animal studies have shown that coenzyme
Q10 can protect the area of the brain that is damaged in PD. Dr.
Shults and colleagues also conducted a pilot study with PD patients
which showed that consumption of up to 800 mg/day of coenzyme Q10
was well-tolerated and significantly increased the level of coenzyme
Q10 in the blood.
All of the patients who took part in the new study
had the three primary features of PD - tremor, stiffness, and slowed
movements - and had been diagnosed with the disease within 5 years
of the time they were enrolled. After an initial screening and baseline
blood tests, the patients were randomly divided into four groups.
Three of the groups received coenzyme Q10 at three different doses
(300 mg/day, 600 mg/day, and 1,200 mg/day), along with vitamin E,
while a fourth group received a matching placebo that contained
vitamin E alone. Each participant received a clinical evaluation
1 month later and every 4 months for a total of 16 months or until
the investigator determined that the patient needed treatment with
levodopa. None of the participants or the study investigators knew
which treatment each patient had received until the study ended.
The investigators found that most side effects of coenzyme Q10 were
mild, and none of the patients required a reduction of their dose.
The percentage of people receiving coenzyme Q10 who reported side
effects was not significantly different from that of the placebo
group.
During the study period, the group that received
the largest dose of coenzyme Q10 (1,200 mg/day) had 44 percent less
decline in mental function, motor (movement) function, and ability
to carry out activities of daily living, such as feeding or dressing
themselves. The greatest effect was on activities of daily
living. The groups that received 300 mg/day and 600 mg/day developed
slightly less disability than the placebo group, but the effects
were less than those in the group that received the highest dosage
of coenzyme Q10.
The groups that received coenzyme Q10 also had significant
increases in the level of coenzyme Q10 in their blood and a significant
increase in energy-producing reactions within their mitochondria.
The results of this study suggest that doses
of coenzyme Q10 as high as 1,200 mg/day are safe and may be more
effective than lower doses, says Dr. Shults. The findings
are consistent with those of a recently published study of patients
with early Huntington's disease - another degenerative neurological
disorder - that showed slightly less functional decline in groups
that received 600 mg/day of coenzyme Q10.
The new study also used an efficient phase II clinical
trial design - developed by biostatistician David Oakes, Ph.D.,
of the University of Rochester, and other study investigators -
which should be useful for testing other drugs that might slow the
progression of PD, says Dr. Shults. The design allowed the researchers
to study the effects of three doses plus a placebo in less than
3 years, and to obtain useful data about the compound's effectiveness.
Dr. Shults and his colleagues strongly caution
patients against taking coenzyme Q10 until a larger, definitive
trial can be conducted. (epic4health note: Please discuss
with your local health care professional BEFORE starting any CoQ10
supplementation.)
Because coenzyme Q10 is classified as a dietary supplement,
it is not regulated by the U.S. Food and Drug Administration. The
versions of the supplement sold in stores may differ, they may not
contain potentially beneficial amounts of the compound, and taking
coenzyme Q10 over a number of years may be costly, says Dr. Shults.
In addition, the current study included only a small number of patients,
and the findings may not extend to people in later stages of PD
or to those who are at risk but have not been diagnosed with the
disorder, he notes. Finally, if many people begin taking coenzyme
Q10 because of these early results, it might make it impossible
for investigators to find enough patients to carry out definitive
studies of the compound's effectiveness and the proper dosages,
since patients must not be taking any treatments in order to be
considered for enrollment in a definitive trial.
The investigators are now planning a larger clinical
trial that will examine the effects of 1,200 mg/day of coenzyme
Q10, and possibly a higher dose as well, in a larger number of patients.
The NINDS is a component of the National Institutes
of Health in Bethesda, Maryland, and is the nation's primary supporter
of biomedical research on the brain and nervous system.
1Shults CW, Oakes D, Kieburtz K, Beal F, Haas R,
Plumb S, Juncos JL, Nutt J, Shoulson I, Carter J, Kompoliti K, Perlmutter
JS, Reich S, Stern M, Watts RL, Kurlan R, Molho E, Harrison M, Lew
M, and the Parkinson Study Group. "Effects of coenzyme Q10
in early Parkinson disease: evidence of slowing of the functional
decline." Archives of Neurology, October 2002, Vol. 59, No.
10, pp. 1541-1550.
Below is link to National Institute of Neurological
Disorders and Stroke (NINDS) web page: You can copy and
paste it in your web browser to go to the NINDS site.
http://www.ninds.nih.gov/news_and_events/pressrelease_parkinsons_coenzymeq10_101402.htm
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