Effect of high-dose creatine therapy on symptoms of exercise intolerance in McArdle disease: double-blind, placebo-controlled crossover study
Vorgerd M, Zange J, Kley R, Grehl T, Hüsing A, Jäger M, Müller K, Schröder R, Mortier W, Fabian K, Malin JP, Luttmann A
Archives of neurology · 62 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2002-01-01 · Arch Neurol · vol. 59 · número 1 · págs. 97–101
- Editorial
- National Institutes of Health
- Citado
- 102 citas · más que el 92% de estudios similares · 3.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 27 trabajos
- Acceso
- De pago
- Áreas de investigación
- Glycogen Storage Diseases and Myoclonus · Muscle metabolism and nutrition · Metabolism and Genetic Disorders
- Palabras clave
- McArdle disease, creatine supplementation, exercise intolerance, exercise-induced muscle pain, creatine kinase, phosphorus-31 magnetic resonance spectroscopy, surface electromyography, glycogen storage disease type V, body mass index
- MeSH
- humans, glycogen storage disease type v, phosphorus isotopes, creatine, electromyography, treatment failure, exercise, magnetic resonance spectroscopy, cross-over studies, double-blind method, muscle fatigue, adolescent, adult, middle aged, child, female, male
12 autores
- Matthias Vorgerd🇩🇪BG University Hospital Bergmannsheil Bochum; Ruhr University Bochum
- Jochen Zange
- Rudolf Andre Kley
- Torsten Grehl
- Anika Hüsing
- Matthias Jäger
- Klaus Müller
- Rolf Schröder
- Wilhelm Mortier
- Klaus Fabian
- J.-P. Malin
- Alwin Luttmann
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
In a recent study, we showed that administration of low-dose creatine (Cr) (60 mg/kg daily) improved work capacity in patients with McArdle disease.
Objective
To assess the efficacy of high-dose Cr therapy in McArdle disease.
Design
Randomized, double-blind, placebo-controlled crossover study.
Patients
Nineteen patients with McArdle disease.
Intervention
Treatment with Cr, 150 mg/kg daily. Each treatment phase with Cr or placebo lasted 5 weeks.
Main outcome measures
The patient's daily rating of symptoms of exercise intolerance. At the end of each treatment phase, serum creatine and serum creatine kinase levels, phosphorus 31 magnetic resonance spectroscopy, and surface electromyograms were assessed.
Results
Clinical end points revealed increases in the intensity of exercise-induced pain in working muscles (mean treatment-induced difference [d], 0.30 in log(score); 95% confidence interval [CI], 0.05-0.55; P =.02), the limitation of daily activities (d, 0.59; 95% CI, 0.22-0.97;P =.005), and body mass index (d, 0.33 kg/m2, 95% CI, 0.10-0.56 kg/m2; P =.008) with Cr use. Surface electromyograms revealed a smaller increase in the electromyographic amplitude over time during muscle contraction with Cr use (d, -13.52%/min; 95% CI, -23.71%/min to -3.34%/min; P =.01). There were no significant changes in phosphorus 31 magnetic resonance spectroscopy variables.
Conclusions
Administration of high-dose Cr worsened the main clinical symptoms of exercise intolerance in McArdle disease. These neurologic adverse effects represent a major dose-limiting factor in Cr therapy for McArdle disease. Taken together with results of a previous study, the indication for symptomatic therapy with Cr needs to be clarified. An effective Cr dosage without adverse effects may be between 60 and 150 mg/kg daily.
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