RT Journal Article
SR Electronic
T1 The Effect of Creatine Supplementation on Muscle Function in Childhood Myositis: A Randomized, Double-blind, Placebo-controlled Feasibility Study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 434
OP 441
DO 10.3899/jrheum.191375
VO 48
IS 3
A1 Saunya Dover
A1 Samantha Stephens
A1 Jane E. Schneiderman
A1 Eleanor Pullenayegum
A1 Greg D. Wells
A1 Deborah M. Levy
A1 Jo-Anne Marcuz
A1 Kristi Whitney
A1 Andreas Schulze
A1 Ingrid Tein
A1 Brian M. Feldman
YR 2021
UL http://www.jrheum.org/content/48/3/434.abstract
AB 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.