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Creatine Supplementation Prevents Statin-Induced Muscle Toxicity

David A. Shewmon, MD; and John M. Craig, BA
[+] Article, Author, and Disclosure Information

From Cleveland Clinic Foundation, Wooster, OH 44691; and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205.

Potential Conflicts of Interest: None disclosed.

Ann Intern Med. 2010;153(10):690-692. doi:10.7326/0003-4819-153-10-201011160-00024
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Changes in myopathy score from baseline over time in 10 of the 12 patients.

Two patients were removed from the study during the loading dose of creatine, before statin therapy: 1 had shoulder pain (shown to be arthritis), and 1 had chest pain and worsened hypertension (possible nonadherence to therapy). Both had negative cardiac stress test results. The myopathy score is the difference, expressed as mean (SD), from baseline in the sum of 3 patient-reported scores on a visual analog scale (range, 0 to 10) for muscle-toxicity symptoms of ache, weakness, and cramping. NS = not significant.

* Two patients reported symptoms during the creatine maintenance plus statin treatment phase: 1 withdrew from the study, and the other was given creatine reloading while statin therapy continued.

† Treatment was creatine, 5 g twice daily, for 5 d (creatine loading); creatine, 5 g/d, with statin for 6 wk or until onset of muscle-toxicity symptoms (creatine maintenance plus statin); statin only until onset of muscle-toxicity symptoms (statin only); and creatine, 5 g twice daily, with continued statin therapy for 5 d (creatine reloading plus statin).

P values for Wilcoxon matched-pairs signed-rank test (2-tailed).

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