Creatine supplementation may improve muscle metabolism in childhood myositis

Supplementation with creatine in children with juvenile dermatomyositis (JDM) is not only feasible but safe and well-tolerated as well, potentially resulting in improvements in muscle metabolism, results of a study have shown.

The investigators conducted a 6-month, double-blind, randomized, multiple-baseline study, in which patients were assigned to either creatine supplementation or placebo. They assessed feasibility using attended study visits, completed study procedures, and adherence.

Standardized exercise tests were used to examine muscle function, aerobic capacity, and muscle strength; a 31-Phosphorus Magnetic Resonance Spectroscopy protocol to assess muscle metabolism; and questionnaires to evaluate fatigue, physical activity, and quality of life (QoL).

The investigators estimated statistical significance using a randomization (permutation) test and calculated changes in outcome measures taken at baseline and end of study using paired t­-tests.

Median adherence to creatine supplementation stood at 88.5 percent (range, 20.5–95.5), while the proportion of participants with ≥80-percent adherence was 76.9 percent. No study visits were missed.

Furthermore, no statistically significant changes were observed in muscle function, strength, aerobic capacity, disease activity, fatigue, physical activity, or QoL while participants were receiving creatine compared to placebo.

At the end of study, statistically significant adaptations were seen in muscle metabolism (eg, decrease in change in muscle pH following exercise and decrease in phosphate/phosphocreatine ratio) relative to baseline. Significant adverse effects were not reported.