Creatine Effective In Protecting Degenerating Motor Neurons

FROM ALSA'S NATIONAL OFFICE March 10,1999

The study published in Nature Medicine was authored by several doctors, including M. Flint Heal, M.D. of Comell Univers New York. The study abstract is entitled "Neuroprotective effects of creatine in a transgenic animal model of amyotrophic I; sclerosis." The study found that animals given a diet high in creatine had the same amount of healthy muscle-controlling nerve cells as mice in their control group. A copy of the full study is being sent to the ALS Association office and will be on file i1 Patient Services department.

Hiroshi Mitsumoto, M.D. Conunittee Chairman, ALSA Medical Advisory Committee and Director of the ALSA Center, Cleveland Clinic responded to the study on behalf of The ALS Association. "The study done by Klivenvi and colleagues is clear and convincing that creatine is effective in protecting degenerating motor neurons and delaying disease deterioration in transgenic mice. Even if creatine has not directly related to the cause of the disease, this chemical appears to improve cell dl Dfocess of ALS motor neurons as almost symptomatic treatment. Clinical trials are of utmost importance to investigate if this is also true in patients with ALS."

Adds Dr. Mitsumoto, "However, as other experts have already made comments, clinical trials with such a widely-available I rood item will be extremely difficult. Another serious question is whether this exciting result found in a model of familial AJ applicable to sporadic ALS that constitutes more than 90% of all ALS. I am quite sure that a lot of patients with ALS will add creatine to their medication list."

Creatine is an anlino acid formed by methylation of quaniamoacetic acid and occurring in vertebrate tissue particularly in muscle. Phosphorylated creatine is an important storage form of high energy phosphate, the energy source for muscle contraction. Some athletes and body builders also use it as a dietary supplement.

ALS should discuss taking creatine with their physicians before taking the compound. PALS who choose to take creatine should follow the label instructions. Instructions for a loading dose is usually included to increase the blood and tissue levels, follo' Dy a lower maintenance dose.

Published reports about the study indicate that Dr. Bears mouse study demonstrated "complete protection (from ALS) up to months, when the disease would normally have begun to take hold." At this time, this is the only information we have on the results.

We are unclear at this time if the study has determined why and how the creatine worked to provide protection and if it its reasonable to believe that creatine would be helpful in humans.

Since the FDA does not regulate dietary supplements like creatine, the compound may not be as pure as we would like it to is important that patients adhere to the label dose recommendations and not exceed label dosage instructions.

Some questions have arisen as to any drug interaction between Rilutek and creatine, ALSA is in contact with a representative who will provide further information as it is available.

ALSA contacted Dominic Marchose, RPh and Pharmacy Specialist at Athena Rx Partnership for Care Program. He sent information about drug interactions with Rilutek indicating that there have been no clinical studies designed to evaluate the interaction of riluzole with other drugs.

The Carolinas Neuromuscular ALS Center is beginning a placebo-controlled, multi centered trial of an ultra-purified form of creatine in ALS patients.

Contact 1-800-924- 7620 or (704) 446-6257 in Charlotte, NC or
The South Texas ALS Clinic (210) 567-1945