TY - JOUR

T1 - Can creatine supplementation improve body composition and objective physical function in rheumatoid arthritis patients? A randomised controlled trial

AU - Wilkinson, T.J.

AU - Lemmey, A.B.

AU - Jones, J.

AU - Sheikh, F.

AU - Ahmad, Y.

AU - Chitale, S.

AU - Maddison, P.J.

AU - O'Brien, T.D.

N1 - This is the peer reviewed version of the following article: "Can creatine supplementation improve body composition and objective physical function in rheumatoid arthritis patients? A randomised controlled trial", which has been published in final form at http://dx.doi.org/10.1002/acr.22747. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Betsi Cadwaladr University Health Board (BCUHB); Small Grants Committee (UK)

PY - 2016/6

Y1 - 2016/6

N2 - Rheumatoid cachexia (muscle wasting) in rheumatoid arthritis (RA) patients contributes to substantial reductions in strength and impaired physical function. The objective of this randomised control trial was to investigate the effectiveness of oral creatine (Cr) supplementation in increasing lean mass and improving strength and physical function in RA patients. Method. In a double-blind design, 40 RA patients, were randomised to either 12 weeks supplementation of Cr or placebo. Body composition (dual energy x-ray absorptiometry, DXA, and bioelectrical impedance spectroscopy, BIS), strength and objectively-assessed physical function were measured at: baseline, day 6, week 12 and week 24. Data analysis was performed by ANCOVA. Results. Creatine supplementation increased appendicular lean mass (ALM; a surrogate measure of muscle mass) by 0.52 (± 0.13) kg (P = 0.004 versus placebo), and total LM by 0.60 (± 0.37) kg (P = 0.158). The change in LM concurred with the gain in intracellular water (0.64 ± 0.22 L, P = 0.035) measured by BIS. Despite increasing ALM, Cr supplementation, relative to placebo, failed to improve isometric knee extensor (P = 0.408), handgrip strength (P = 0.833), or objectively-assessed physical function (P's = 0.335 – 0.764). Conclusion. In patients with RA, creatine supplementation increased muscle mass, but not strength or objective physical function. No treatment-related adverse effects were reported suggesting that Cr supplementation may offer a safe and acceptable adjunct treatment for attenuating muscle loss; this treatment may be beneficial for patients suffering from severe rheumatoid cachexia

AB - Rheumatoid cachexia (muscle wasting) in rheumatoid arthritis (RA) patients contributes to substantial reductions in strength and impaired physical function. The objective of this randomised control trial was to investigate the effectiveness of oral creatine (Cr) supplementation in increasing lean mass and improving strength and physical function in RA patients. Method. In a double-blind design, 40 RA patients, were randomised to either 12 weeks supplementation of Cr or placebo. Body composition (dual energy x-ray absorptiometry, DXA, and bioelectrical impedance spectroscopy, BIS), strength and objectively-assessed physical function were measured at: baseline, day 6, week 12 and week 24. Data analysis was performed by ANCOVA. Results. Creatine supplementation increased appendicular lean mass (ALM; a surrogate measure of muscle mass) by 0.52 (± 0.13) kg (P = 0.004 versus placebo), and total LM by 0.60 (± 0.37) kg (P = 0.158). The change in LM concurred with the gain in intracellular water (0.64 ± 0.22 L, P = 0.035) measured by BIS. Despite increasing ALM, Cr supplementation, relative to placebo, failed to improve isometric knee extensor (P = 0.408), handgrip strength (P = 0.833), or objectively-assessed physical function (P's = 0.335 – 0.764). Conclusion. In patients with RA, creatine supplementation increased muscle mass, but not strength or objective physical function. No treatment-related adverse effects were reported suggesting that Cr supplementation may offer a safe and acceptable adjunct treatment for attenuating muscle loss; this treatment may be beneficial for patients suffering from severe rheumatoid cachexia

U2 - 10.1002/acr.22747

DO - 10.1002/acr.22747

M3 - Article

VL - 68

SP - 729

EP - 737

JO - Arthritis Care and Research

JF - Arthritis Care and Research

SN - 2151-4658

IS - 6

ER -