Creatine Supplements May Improve Muscle Strength in Young Children With DMD

October 23, 2003

Martha Kerr

Oct. 23, 2003 (San Francisco) -- Young children with Duchenne muscular dystrophy (DMD) show improved muscle strength and functional status and evidence of a slowing of disease progression with creatine supplements, researchers reported at the 128th annual meeting of the American Neurological Association.

A study of 60 children with DMD between the ages of five and nine years was conducted, based on studies of animal models of DMD that showed that glutamine and creatine supplementation prevented loss of muscle strength compared with prednisone.

Lead investigator Diana M. Escolar, MD, from the Children's National Medical Center at George Washington University in Washington, D.C., and the Cooperative International Neuromuscular Research Group, randomized the children to one of three arms: creatine 5 g daily plus placebo twice daily, glutamine 0.3 mg/kg daily plus placebo twice daily, or placebo twice daily alone. Dr. Escolar noted that the investigators were comparing creatine versus placebo and glutamine versus placebo, but not creatine versus glutamine.

The primary outcome measure was manual muscle strength (MMT, 34 muscle groups) and the secondary outcome measure was quantitative muscle strength (QMT, seven muscle groups), which measured functional status using various physical activities.

"We found very different outcomes in the 30 children in the younger age group [between the ages of five and seven years] and the 30 children in the older group [between the ages of seven and nine years] on the primary outcome measure," Dr. Escolar told Medscape.

In the six-month study, MMT scores did not significantly differ between the three groups of the study, Dr. Escolar reported. But on QMT scores, children in the placebo group showed more deterioration in muscle strength compared with children in the two treatment groups. Children randomized to creatine showed a lesser degree of deterioration than children receiving glutamine. Children in the younger age group scored higher on measures of functionality such as standing, climbing, and running than the older children receiving creatine.

"I have a theory to explain this," Dr. Escolar said. "These compounds improve muscle energy. Younger kids have muscles that respond more to an increase in energy than older kids.... They don't need more strength, they just need more energy. For the older kids, an increase in strength translates to an increase in functionality." Dr. Escolar said it is possible that the energy supplements may even slow the progression of DMD.

While she stressed that there was only a trend toward increased functionality in the younger children rather than a statistically strong outcome, she pointed out that creatine and glutamine have very minimal adverse effects. "If parents want to go out and buy these supplements, I wouldn't care if they do," Dr. Escolar asserted.

ANA 128th Annual Meeting: Poster WIP7. Presented Oct. 21, 2003.

Reviewed by Gary D. Vogin, MD

Martha Kerr is a freelance writer for Medscape.


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