Efficacy and safety of creatine supplementation in childhood-onset systemic lupus erythematosus: a randomized, double-blind, placebo-controlled, crossover trial

Autor(es)

Hayashi, A. P. ^[1] ; Solis, M. Y. ^[2] ; Sapienza, M. T. ^[3] ; Otaduy, M. C. G. ^[4] ; Pinto, A. L. de Sa ^[5] ; Silva, C. A. ^[6] ; Sallum, A. M. E. ^[7] ; Pereira, R. M. R. ^[8] ; Gualano, B. ^[9]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo. Sch Med

^[2] Univ Sao Paulo. Sch Med

^[3] Univ Sao Paulo. Sch Med

^[4] Univ Sao Paulo. Sch Med

^[5] Univ Sao Paulo. Sch Med

^[6] Univ Sao Paulo. Sch Med

^[7] Univ Sao Paulo. Sch Med

^[8] Univ Sao Paulo. Sch Med

^[9] Div Reumatol. Av Dr Arnaldo 455

• Tipo de documento: Artigo Científico
• Fonte: Lupus; v. 23, n. 14, p. 1500-1511, DEC 2014.
• Citações Web of Science: 0

Resumo

Introduction: Creatine supplementation has emerged as a promising non-pharmacological therapeutic strategy to counteract muscle dysfunction and low lean mass in a variety of conditions, including in pediatric and rheumatic diseases. The objective of this study was to examine the efficacy and safety of creatine supplementation in childhood systemic lupus erythematosus (C-SLE). Methods: C-SLE patients with mild disease activity (n = 15) received placebo or creatine supplementation in a randomized fashion using a crossover, double-blind, repeated-measures design. The participants were assessed at baseline and after 12 weeks in each arm, interspersed by an eight-week washout period. The primary outcomes were muscle function, as assessed by a battery of tests including one-maximum repetition (1-RM) tests, the timed-up-and-go test, the timed-stands test, and the handgrip test. Secondary outcomes included body composition, biochemical markers of bone remodeling, aerobic conditioning, quality of life, and physical capacity. Possible differences in dietary intake were assessed by three 24-hour dietary recalls. Muscle phosphorylcreatine content was measured through phosphorus magnetic resonance spectroscopy (31 P-MRS). The safety of the intervention was assessed by laboratory parameters, and kidney function was measured by 51 Cr-EDTA clearance. Additionally, self-reported adverse events were recorded throughout the trial. Results: Intramuscular phosphorylcreatine content was not significantly different between creatine and placebo before or after the intervention (creatine-Pre: 20.5 +/- 2.6, Post: 20.4 +/- 4.1, placebo-Pre: 19.8 +/- 2.0; Post: 20.2 +/- 3.2 mmol/kg wet muscle; p = 0.70 for interaction between conditions). In addition, probably as a consequence of the lack of change in intramuscular phosphorylcreatine content, there were no significant changes between placebo and creatine for any muscle function and aerobic conditioning parameters, lean mass, fat mass, bone mass, and quality of life scores (p > 0.05). The 51 Cr-EDTA clearance was not altered by creatine supplementation and no side effects were noticed. Conclusion: A 12-week creatine supplementation protocol at 0.1 g/kg/d is well tolerated and free of adverse effects but did not affect intramuscular phosphorylcreatine, muscle function, free-fat mass or quality of life in non-active C-SLE patients. (AU)

• Processo FAPESP: 10/18708-1 - Eficácia e segurança da suplementação de cretaina em pacientes com dermatomiosite de início juvenil e lúpus eritematoso sistêmico de início juvenil
• Beneficiário: Bruno Gualano
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 08/58238-4 - Autoimunidade na criança: investigação das bases moleculares e celulares da autoimunidade de início precoce
• Beneficiário: Magda Maria Sales Carneiro-Sampaio
• Modalidade de apoio: Auxílio à Pesquisa - Temático