The Effect of Creatine Supplementation on Muscle Function in Childhood Myositis: A Randomized, Double-blind, Placebo-controlled Feasibility Study

Affiliations

¹ S. Dover, MSc, Child Health Evaluative Sciences, The Hospital for Sick Children.
² S. Stephens, PhD, Neurosciences and Mental Health, The Hospital for Sick Children.
³ J.E. Schneiderman, PhD, RKin, CEP, Clinical Research Services, Research Institute, The Hospital for Sick Children, and Faculty of Kinesiology and Physical Education, University of Toronto.
⁴ E. Pullenayegum, PhD, Child Health Evaluative Sciences, The Hospital for Sick Children, and Institute of Health Policy, Management and Evaluation, the Dalla Lana School of Public Health, University of Toronto.
⁵ G.D. Wells, PhD, Translational Medicine, The Hospital for Sick Children.
⁶ D.M. Levy, MD, MS, FRCPC, Child Health Evaluative Sciences, The Hospital for Sick Children, and Department of Pediatrics, Faculty of Medicine, University of Toronto, and Division of Rheumatology, The Hospital for Sick Children.
⁷ J.A. Marcuz, MScPT, K. Whitney, MSc, BScPT, Division of Rheumatology, The Hospital for Sick Children, and Department of Rehabilitation, The Hospital for Sick Children.
⁸ A. Schulze, MD, PhD, Clinical and Metabolic Genetics, The Hospital for Sick Children.
⁹ I. Tein, MD, FRCPC, Division of Neurology, Department of Pediatrics and Genetics and Genome Biology Program, The Hospital for Sick Children, and Department of Laboratory Medicine and Pathobiology, University of Toronto.
¹⁰ B.M. Feldman, MD, MSc, FRCPC, Child Health Evaluative Sciences, The Hospital for Sick Children, and Institute of Health Policy, Management & Evaluation, the Dalla Lana School of Public Health, University of Toronto, and Department of Pediatrics, Faculty of Medicine, University of Toronto, and Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada. brian.feldman@sickkids.ca.

PMID: 32739897
DOI: 10.3899/jrheum.191375

Randomized Controlled Trial

The Effect of Creatine Supplementation on Muscle Function in Childhood Myositis: A Randomized, Double-blind, Placebo-controlled Feasibility Study

Saunya Dover et al. J Rheumatol. 2021 Mar.

. 2021 Mar;48(3):434-441.

doi: 10.3899/jrheum.191375. Epub 2020 Aug 1.

Authors

Affiliations

¹ S. Dover, MSc, Child Health Evaluative Sciences, The Hospital for Sick Children.
² S. Stephens, PhD, Neurosciences and Mental Health, The Hospital for Sick Children.
³ J.E. Schneiderman, PhD, RKin, CEP, Clinical Research Services, Research Institute, The Hospital for Sick Children, and Faculty of Kinesiology and Physical Education, University of Toronto.
⁴ E. Pullenayegum, PhD, Child Health Evaluative Sciences, The Hospital for Sick Children, and Institute of Health Policy, Management and Evaluation, the Dalla Lana School of Public Health, University of Toronto.
⁵ G.D. Wells, PhD, Translational Medicine, The Hospital for Sick Children.
⁶ D.M. Levy, MD, MS, FRCPC, Child Health Evaluative Sciences, The Hospital for Sick Children, and Department of Pediatrics, Faculty of Medicine, University of Toronto, and Division of Rheumatology, The Hospital for Sick Children.
⁷ J.A. Marcuz, MScPT, K. Whitney, MSc, BScPT, Division of Rheumatology, The Hospital for Sick Children, and Department of Rehabilitation, The Hospital for Sick Children.
⁸ A. Schulze, MD, PhD, Clinical and Metabolic Genetics, The Hospital for Sick Children.
⁹ I. Tein, MD, FRCPC, Division of Neurology, Department of Pediatrics and Genetics and Genome Biology Program, The Hospital for Sick Children, and Department of Laboratory Medicine and Pathobiology, University of Toronto.
¹⁰ B.M. Feldman, MD, MSc, FRCPC, Child Health Evaluative Sciences, The Hospital for Sick Children, and Institute of Health Policy, Management & Evaluation, the Dalla Lana School of Public Health, University of Toronto, and Department of Pediatrics, Faculty of Medicine, University of Toronto, and Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada. brian.feldman@sickkids.ca.

PMID: 32739897
DOI: 10.3899/jrheum.191375

Abstract

Objective: To evaluate the feasibility of studying creatine in juvenile dermatomyositis (JDM). Secondary objectives were to determine the effect of creatine on muscle function and metabolism, aerobic capacity, fatigue, physical activity, and quality of life (QOL), as well as its safety.

Methods: We conducted a 6-month, double-blind, randomized, multiple-baseline design; patients were assigned to creatine or placebo. Feasibility was assessed using attended study visits, completed study procedures, and adherence. Muscle function, aerobic capacity, and muscle strength were assessed with standardized exercise tests. Muscle metabolism was assessed using a 31-Phosphorus Magnetic Resonance Spectroscopy protocol. Fatigue, physical activity, and QOL were assessed by questionnaires. Statistical significance was estimated using a randomization (permutation) test. Changes in outcome measures taken at baseline and end-of-study were calculated using paired t-tests.

Results: Median (range) adherence to the study drug was 88.5% (20.5-95.5%) and the proportion of subjects with 80% adherence or higher was 76.9%. There were no missed study visits. There were no statistically significant changes in muscle function, strength, aerobic capacity, disease activity, fatigue, physical activity, or QOL while subjects were receiving creatine compared to placebo. There were statistically significant adaptations in muscle metabolism (e.g., decrease in change in muscle pH following exercise, and decrease in phosphate/phosphocreatine ratio) at the end-of-study compared to baseline. There were no significant adverse effects.

Conclusion: Creatine supplementation in children with JDM is feasible to study, and is safe and well-tolerated; it may lead to improvements in muscle metabolism.

Keywords: creatine; exercise test; magnetic resonance spectroscopy; pediatric dermatomyositis; pediatric polymyositis; randomized controlled trial.

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The Effect of Creatine Supplementation on Muscle Function in Childhood Myositis: A Randomized, Double-blind, Placebo-controlled Feasibility Study

Affiliations

The Effect of Creatine Supplementation on Muscle Function in Childhood Myositis: A Randomized, Double-blind, Placebo-controlled Feasibility Study

Authors

Affiliations

Abstract

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Substances

LinkOut - more resources

Full Text Sources

Medical