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Creatine supplements in patients with idiopathic inflammatory myopathies who are clinically weak after conventional pharmacologic treatment: Six-month, double-blind, randomized, placebo-controlled trial

Chung, Yuen-Li; Alexanderson, Helene; Pipitone, Nicolo; Morrison, Catherine; Dastmalchi, Maryam; Ståhl Hallengren, Christina LU ; Richards, Selwyn; Thomas, E. Louise; Hamilton, Gavin and Bell, Jimmy D., et al. (2007) In Arthritis and Rheumatism 57(4). p.694-702
Abstract
Objective. To test the hypothesis that oral creatine supplements with exercise are more effective than exercise alone in improving muscle function in patients with established dermatomyositis or polymyositis receiving chronic medical therapies who are clinically weak yet stable. Methods. In a 6-month, 2-center, double-blind, randomized controlled trial, patients were randomized to receive oral creatine supplements (8 days, 20 gm/day then 3 gm/day) or placebo. All patients followed a home exercise program. The primary outcome was aggregate functional performance time (AFPT), reflecting the ability to undertake high-intensity exercise. Secondary outcomes included a Functional index measuring endurance and muscle bioenergetics on P-31... (More)
Objective. To test the hypothesis that oral creatine supplements with exercise are more effective than exercise alone in improving muscle function in patients with established dermatomyositis or polymyositis receiving chronic medical therapies who are clinically weak yet stable. Methods. In a 6-month, 2-center, double-blind, randomized controlled trial, patients were randomized to receive oral creatine supplements (8 days, 20 gm/day then 3 gm/day) or placebo. All patients followed a home exercise program. The primary outcome was aggregate functional performance time (AFPT), reflecting the ability to undertake high-intensity exercise. Secondary outcomes included a Functional index measuring endurance and muscle bioenergetics on P-31 magnetic resonance spectroscopy (P-31 MRS). Patients were receiving stable immunosuppressive treatment and/or corticosteroids. Results. A total of 37 patients with polymyositis or dermatomyositis were randomized (19 to creatine, 18 to placebo); 29 completed 6 months. Intent-to-treat analyses demonstrated that AFPT improved significantly at 6 months with creatine (median decrease 13%, range -32-8%) compared with placebo (median decrease 3%, range -13-16%; P = 0.029 by Mann-Whitney U test). A completer analysis also showed significant benefits from creatine (P = 0.014). The functional index improved significantly with both creatine and placebo (P < 0.05 by paired Wilcoxon's rank sum test), with a significant benefit between groups in the completer analysis only. Phosphocreatine/beta-nucleoside triphosphate ratios using MRS increased significantly in the creatine group (P < 0.05) but not in the control group. No clinically relevant adverse events were associated with creatine. Conclusion. Oral creatine supplements combined with home exercises improve functional performance without significant adverse effects in patients with polymyositis or dermatomyositis. They appear safe, effective, and inexpensive. (Less)
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Contribution to journal
publication status
published
subject
keywords
P-31 magnetic resonance spectroscopy, muscle function, exercise, creatine supplementation, dermatomyositis, polymyositis
in
Arthritis and Rheumatism
volume
57
issue
4
pages
694 - 702
publisher
John Wiley & Sons
external identifiers
  • wos:000246384900023
  • scopus:34248589200
ISSN
1529-0131
DOI
10.1002/art.22687
language
English
LU publication?
yes
id
daf8728b-5bd3-4668-9b08-7046aab947a2 (old id 660600)
date added to LUP
2007-12-10 10:15:10
date last changed
2017-10-22 03:43:55
@article{daf8728b-5bd3-4668-9b08-7046aab947a2,
  abstract     = {Objective. To test the hypothesis that oral creatine supplements with exercise are more effective than exercise alone in improving muscle function in patients with established dermatomyositis or polymyositis receiving chronic medical therapies who are clinically weak yet stable. Methods. In a 6-month, 2-center, double-blind, randomized controlled trial, patients were randomized to receive oral creatine supplements (8 days, 20 gm/day then 3 gm/day) or placebo. All patients followed a home exercise program. The primary outcome was aggregate functional performance time (AFPT), reflecting the ability to undertake high-intensity exercise. Secondary outcomes included a Functional index measuring endurance and muscle bioenergetics on P-31 magnetic resonance spectroscopy (P-31 MRS). Patients were receiving stable immunosuppressive treatment and/or corticosteroids. Results. A total of 37 patients with polymyositis or dermatomyositis were randomized (19 to creatine, 18 to placebo); 29 completed 6 months. Intent-to-treat analyses demonstrated that AFPT improved significantly at 6 months with creatine (median decrease 13%, range -32-8%) compared with placebo (median decrease 3%, range -13-16%; P = 0.029 by Mann-Whitney U test). A completer analysis also showed significant benefits from creatine (P = 0.014). The functional index improved significantly with both creatine and placebo (P &lt; 0.05 by paired Wilcoxon's rank sum test), with a significant benefit between groups in the completer analysis only. Phosphocreatine/beta-nucleoside triphosphate ratios using MRS increased significantly in the creatine group (P &lt; 0.05) but not in the control group. No clinically relevant adverse events were associated with creatine. Conclusion. Oral creatine supplements combined with home exercises improve functional performance without significant adverse effects in patients with polymyositis or dermatomyositis. They appear safe, effective, and inexpensive.},
  author       = {Chung, Yuen-Li and Alexanderson, Helene and Pipitone, Nicolo and Morrison, Catherine and Dastmalchi, Maryam and Ståhl Hallengren, Christina and Richards, Selwyn and Thomas, E. Louise and Hamilton, Gavin and Bell, Jimmy D. and Lundberg, Ingrid E. and Scott, David L.},
  issn         = {1529-0131},
  keyword      = {P-31 magnetic resonance spectroscopy,muscle function,exercise,creatine supplementation,dermatomyositis,polymyositis},
  language     = {eng},
  number       = {4},
  pages        = {694--702},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis and Rheumatism},
  title        = {Creatine supplements in patients with idiopathic inflammatory myopathies who are clinically weak after conventional pharmacologic treatment: Six-month, double-blind, randomized, placebo-controlled trial},
  url          = {http://dx.doi.org/10.1002/art.22687},
  volume       = {57},
  year         = {2007},
}