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Creatine for Parkinson's disease.

Abstract

BACKGROUND

Parkinson's disease is one of the most common neurodegenerative disorders and mitochondrial dysfunction plays an important role in its pathogenesis. Creatine is effective in improving mitochondrial function. It may therefore be useful for slowing the progression of Parkinson's disease.

OBJECTIVES

To assess the efficacy and safety of creatine used alone or as an adjuvant treatment for Parkinson's disease.

SEARCH METHODS

We searched the Cochrane Movement Disorders Group Trials Register, CENTRAL (The Cochrane Library 2013, November Issue 4), MEDLINE (January 1966 to 10 November 2013), EMBASE (1974 to 10 November 2013) and two Chinese databases. We searched ongoing trials registers and conference proceedings, checked reference lists and contacted authors of included trials.

SELECTION CRITERIA

Randomized controlled trials (RCTs) comparing creatine versus placebo for Parkinson's disease.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected the trials for inclusion, assessed trial quality and extracted data.

MAIN RESULTS

We included two RCTs with a total of 194 patients. Both trials compared creatine with placebo for Parkinson's disease and both had methodological limitations. There was no clear evidence of an effect on motor function (MD -0.26; 95% confidence interval (CI) -4.39 to 3.88, low quality evidence), activities of daily living (MD 0.37; 95% CI -1.28 to 2.02, low quality evidence) or quality of life after one or two years of treatment. One trial reported serious adverse events that were not attributed to creatine. Also, one trial observed higher rates of gastrointestinal effects at two years follow-up.

AUTHORS' CONCLUSIONS

The evidence base on the effects of creatine in Parkinson's disease is limited by risk of bias, small sample sizes and short duration of the eligible trials. It does not provide a reliable basis on which treatment decisions can be made. Future well-designed RCTs with larger sample size and long-term follow-up are needed to assess creatine for Parkinson's disease.

Authors+Show Affiliations

Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, No. 22, Shuang Yong Lu, Nanning, Guangxi, China, 530021.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

24934384

Citation

Xiao, Yousheng, et al. "Creatine for Parkinson's Disease." The Cochrane Database of Systematic Reviews, 2014, p. CD009646.
Xiao Y, Luo M, Luo H, et al. Creatine for Parkinson's disease. Cochrane Database Syst Rev. 2014.
Xiao, Y., Luo, M., Luo, H., & Wang, J. (2014). Creatine for Parkinson's disease. The Cochrane Database of Systematic Reviews, (6), CD009646. https://doi.org/10.1002/14651858.CD009646.pub2
Xiao Y, et al. Creatine for Parkinson's Disease. Cochrane Database Syst Rev. 2014 Jun 17;(6)CD009646. PubMed PMID: 24934384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Creatine for Parkinson's disease. AU - Xiao,Yousheng, AU - Luo,Man, AU - Luo,Hongye, AU - Wang,Jin, Y1 - 2014/06/17/ PY - 2014/6/18/entrez PY - 2014/6/18/pubmed PY - 2015/10/3/medline SP - CD009646 EP - CD009646 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 6 N2 - BACKGROUND: Parkinson's disease is one of the most common neurodegenerative disorders and mitochondrial dysfunction plays an important role in its pathogenesis. Creatine is effective in improving mitochondrial function. It may therefore be useful for slowing the progression of Parkinson's disease. OBJECTIVES: To assess the efficacy and safety of creatine used alone or as an adjuvant treatment for Parkinson's disease. SEARCH METHODS: We searched the Cochrane Movement Disorders Group Trials Register, CENTRAL (The Cochrane Library 2013, November Issue 4), MEDLINE (January 1966 to 10 November 2013), EMBASE (1974 to 10 November 2013) and two Chinese databases. We searched ongoing trials registers and conference proceedings, checked reference lists and contacted authors of included trials. SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing creatine versus placebo for Parkinson's disease. DATA COLLECTION AND ANALYSIS: Two review authors independently selected the trials for inclusion, assessed trial quality and extracted data. MAIN RESULTS: We included two RCTs with a total of 194 patients. Both trials compared creatine with placebo for Parkinson's disease and both had methodological limitations. There was no clear evidence of an effect on motor function (MD -0.26; 95% confidence interval (CI) -4.39 to 3.88, low quality evidence), activities of daily living (MD 0.37; 95% CI -1.28 to 2.02, low quality evidence) or quality of life after one or two years of treatment. One trial reported serious adverse events that were not attributed to creatine. Also, one trial observed higher rates of gastrointestinal effects at two years follow-up. AUTHORS' CONCLUSIONS: The evidence base on the effects of creatine in Parkinson's disease is limited by risk of bias, small sample sizes and short duration of the eligible trials. It does not provide a reliable basis on which treatment decisions can be made. Future well-designed RCTs with larger sample size and long-term follow-up are needed to assess creatine for Parkinson's disease. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/24934384/Creatine_for_Parkinson's_disease_ L2 - https://doi.org/10.1002/14651858.CD009646.pub2 DB - PRIME DP - Unbound Medicine ER -