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Hereditary muscle diseases usually lead to a progressive muscle weakness. Treatment is mainly symptomatic because curative therapies are lacking. Creatine, a popular nutritional supplement among athletes, improves muscle performance in healthy individuals. This is an update of our first review evaluating creatine treatment in muscle disorders that was published in 2007. We identified two new studies and added ‘changes in activities of daily living’ as outcome measure. Meta-analysis of in total 14 randomised controlled trials of creatine treatment involving 364 participants showed an increase in muscle strength in muscular dystrophies but not in metabolic myopathies. Activities of daily living were improved in muscular dystrophies and inflammatory myopathies. Significant adverse events occurred only in people with glycogen storage disease type V presenting as an increase in muscle pain episodes and impairment in activities of daily living.  —Cochrane Feb 2011



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