Meta-Analysis of Creatine for Neuroprotection Against Parkinson's Disease.
BACKGROUND
Creatine is an antioxidant agent that showed neuroprotective effects in animal models of Parkinson's disease (PD). Creatine was selected by the National Institute of Neurological Disorders and Stroke as a possible disease modifying agent for Parkinson's disease. Therefore, many clinical trials evaluated the efficacy of creatine for patients with PD. The aim of this systematic review and meta-analysis is to synthesize evidence from published randomized controlled trials (RCTs) about the efficacy of Creatine for patients with PD.


METHODS
We followed PRISMA statement guidelines during the preparation of this systematic review and meta-analysis. A computer literature search for PubMed, EBSCO, web of science and Ovid Midline was carried out. We included RCTs comparing creatine with placebo in terms of motor functions and quality of life. Outcomes of total Unified Parkinson's Disease Rating Scale (UPDRS), UPDRS I, UPDRS II, and UPDRS III were pooled as mean difference (MD) between two groups from baseline to the endpoint. Statistical heterogeneity was assessed by visual inspection of the forest plot and measured by chi-square and I square tests.


RESULTS
Three RCTs (n=1935) were included in this study. The overall effect did not favor either of the two groups in terms of: UPDRS total score (MD 1.07, 95% CI [3.38 to 1.25], UPDRS III (MD 0.62, 95% CI [2.27 to 1.02]), UPDRS II (MD 0.03, 95% CI [0.81 to 0.86], or UPDRS I (MD 0.03, 95% CI [0.33 to 0.28]).


CONCLUSIONS
Current evidence does not support the use of creatine for neuroprotection against PD. Future well-designed, randomized controlled trials are needed.
Medical Research Group of Egypt, Cairo, Egypt.
Attia
Medical Research Group of Egypt, Cairo, Egypt.
Hussien
H
Ahmed
Medical Research Group of Egypt, Cairo, Egypt.
Mohamed
M
Gadelkarim
Medical Research Group of Egypt, Cairo, Egypt.
Mahmoud
M
Morsi
Medical Research Group of Egypt, Cairo, Egypt.
Kamal
K
Awad
Medical Research Group of Egypt, Cairo, Egypt.
Mohamed
M
Elnenny
Medical Research Group of Egypt, Cairo, Egypt.
Esraa
E
Ghanem
Medical Research Group of Egypt, Cairo, Egypt.
Shaimaa
S
El-Jaafary
Faculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Postal Code: 44519, Egypt.
Ahmed
A
Negida
D000818:Animals; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003401:Creatine / Q000627:therapeutic use*; D006801:Humans; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
D000978:Antiparkinson Agents; D018696:Neuroprotective Agents; D003401:Creatine
Neuroprotection; Parkinson's disease