Promising efficacy of coenzyme Q10 supplementation as adjunctive therapy in juvenile idiopathic arthritis: a randomized-controlled pilot study

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.Clinical-trials.gov identification number: NCT05871086