Effects of coenzyme Q10 supplementation on matrix metalloproteinases and DAS-28 in patients with rheumatoid arthritis: a randomized, double-blind, placebo-controlled clinical trial

  • Seyed Mostafa Nachvak
  • Beitollah Alipour
  • Aida Malek Mahdavi
  • Mir Amir Aghdashi
  • Hadi AbdollahzadEmail author
  • Yahya Pasdar
  • Mehnoosh Samadi
  • Roghayeh Mostafai
Original Article



This study aimed to assess the effect of CoQ10 supplementation on serum matrix metalloproteinases (MMPs) and clinical parameters in rheumatoid arthritis (RA) patients.


In this randomized, double-blind, placebo-controlled trial, 54 RA patients who fulfilled the eligibility criteria (18–56 years, diagnosed at least 6 months ago, with DAS-28 > 3.2) were randomly assigned into two groups to receive 100 mg/day CoQ10 (n = 27) or placebo (n = 27) for 2 months. Serum MMP-1 and MMP-3 levels and clinical status using disease activity score in 28 joints (DAS-28) were assessed before and after supplementation. Data were analyzed using χ2, independent sample t test, paired t test, Wilcoxon, Mann-Whitney, and analysis of covariance.


A significant reduction was observed in both CoQ10 and placebo groups in the medians of serum MMP-1 (0.2 to 0.16, P < 0.001), (0.18 to 0.15, P = 0.001); swollen joint count (2 to 0, P < 0.001), (2 to 0, P = 0.009); and the means of DAS-28 (5.01 ± 1.21 to 2.34 ± 0.68, P < 0.001), (4.88 ± 0.96 to 4.04 ± 1.36, P = 0.009) respectively. Serum MMP-3 level increased significantly in placebo group (2.26 to 2.57, P = 0.020), and the MMP-3 changes between groups were significant (P = 0.027). Furthermore, significant reductions were only observed in ESR, pain score, and tender joint count in CoQ10 group compared with baseline (P = 0.001, P < 0.001, and P < 0.001, respectively). Significant differences were observed between two groups in DAS-28, pain score, and swollen and tender joint count after the intervention (P < 0.001, P < 0.001, and P = 0.012 and P < 0.001, respectively).


It seems that CoQ10 may provide a new complementary approach for RA patients.

Key Points

• CoQ10 supplementation in RA patients attenuated serum MMP-3 level.

• CoQ10 supplementation in RA patients improved clinical outcomes and ameliorated disease severity.

• CoQ10 may provide a new complementary approach for patients with RA.


Clinical parameters Clinical trial Coenzyme Q10 Matrix metalloproteinases Rheumatoid arthritis 



Analysis of covariance


Body mass index


Coenzyme Q10


Disease activity score-28 joints


Disease-modifying anti-rheumatic drugs


Erythrocyte sedimentation rate


Fibromyalgia Impact Questionnaire


High-sensitivity C-reactive protein








Matrix metalloproteinases




Tumor necrosis factor-alpha


visual analogue scale



We thank all patients for their participation in this study.

Funding information

The research project had a grant from Research Vice Chancellor of Tabriz University of Medical Sciences. The authors thank the Research Vice Chancellor of Tabriz University of Medical Sciences for financial supports.

Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  1. 1.Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
  2. 2.Department of Community Nutrition, Faculty of NutritionTabriz University of Medical SciencesTabrizIran
  3. 3.Connective Tissue Diseases Research CenterTabriz University of Medical SciencesTabrizIran
  4. 4.Department of Rheumatology, Faculty of MedicineUrmia University of Medical SciencesUrmiaIran
  5. 5.Research Center for Environmental Determinants of Health (RCEDH), Health InstituteKermanshah University of Medical SciencesKermanshahIran
  6. 6.Department of Nutrition, Faculty of Nutritional Sciences and Food TechnologiesKermanshahIran

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