Dover S, Stephens S, Schneiderman JE, et al. - In this 6-month, double-blind, randomized, multiple-baseline design, researchers sought to assess the feasibility of studying creatine in juvenile dermatomyositis (JDM) and to determine the impact of creatine on muscle function and metabolism, aerobic capacity, fatigue, physical activity, and quality of life (QOL), as well as its safety. Study participants were assigned to creatine or placebo. Using a 31-Phosphorus Magnetic Resonance Spectroscopy protocol, muscle metabolism was evaluated. No statistically significant changes in muscle function, strength, aerobic capacity, disease activity, fatigue, physical activity, or QOL were observed in subjects receiving creatine compared with placebo. No significant adverse effects were observed. Creatine supplementation in children with JDM can be studied and is safe and well-tolerated; it can lead to improvements in muscle metabolism.