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]).
Conclusion: Current evidence does not support the use of creatine for neuroprotection against PD.
Future well-designed, randomized controlled trials are needed.