Myositis, Juvenile
Conditions
Brief summary
Children with JDM are weak and get tired because their muscles aren't able to work like healthy muscles. This can make it hard for them to do normal everyday things and can make them less happy about their lives compared to children without the disease. There are two nutritional supplements that help muscles use energy and recover after exercise: creatine and coenzyme Q10. If the muscle has more energy, it may not be as weak and may not feel as tired or sore after exercise. Because of this we want to see if having children with JDM take creatine and coenzyme Q10 can make them stronger and less tired. If this works, we hope it will let them be able to do the things that healthy children can do, and make them feel better about their lives.
Interventions
DIETARY_SUPPLEMENTcreatine monohydrate
Creatine will be taken at a dose of 150mg/kg/day of creatine base divided into 2 daily doses up to 39.7kg in body weight, after which dosing will be based on body surface area (BSA) at 4.69g/m2/day. Creatine will be administered orally as a chewable tablet provided by BioTechUSA™. Tablets are 2g and contain 0.9g of creatine monohydrate which is equivalent to 0.8g of creatine base.
DIETARY_SUPPLEMENTubiquinol
Coenzyme Q10 (CoQ10, ubiquinol) will be taken at a dose of 10mg/kg/day divided into 2 daily doses with a daily maximum of 500mg. CoQ10 will be administered orally in 50mg softgels containing 50mg of ubiquinol (Active Q®), provided by Tishcon Corporation.
DIETARY_SUPPLEMENTglucose tablet
Creatine placebo will be in the form of a glucose tablet with identical appearance and taste to the active supplement. The number of tablets/day will be determined based on the dose of creatine required for each patient.
DIETARY_SUPPLEMENTgel capsule
Ubiquinol placebo will be in the form of a gel capsule with identical appearance to the active supplement. The number of capsules/day will be determined based on the dose of ubiquinol required for each patient.
BEHAVIORALExercise
Participants will be coached to hit 12,000 steps or 60 active minutes per day as logged by a FitBit (FitBit calculates active minutes as activities equivalent to moderate-to-vigorous physical activity (MVPA) done continuously for at least 10 minutes)
Sponsors
The Hospital for Sick Children
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Intervention model description
This study will be a double-blinded, placebo-controlled, randomized, multiple baseline design (MBD) where each subject will be randomly allocated a start time for the active supplements
Eligibility
Sex/Gender
ALL
Age
7 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Ages 7 to 18 years * Diagnosis of juvenile idiopathic inflammatory myopathy (JIIM) according to the 2017 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) criteria: ≥90% probability, age of onset \<18 years * Subjects on a stable course of medication (unlikely to change over study treatment period as determined by treating physician) * Minimum height of 132.5cm (required to fit on the cycle ergometer)
Exclusion criteria
* Subjects with newly diagnosed JIIM within the previous 6 months * Subjects unable to cooperate with study procedures, or too weak to participate in the exercise testing * Subjects with impaired kidney function as determined from pre-baseline visit screening lab values (eGFR \<90 ml/min/1.73m\^2) * Subjects currently taking anti-hypertensive drugs or blood thinners * Subjects who are currently pregnant or planning to become pregnant within the study period
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in muscle function | 6 months | Change in muscle function will be determined by the change in peak power achieved on the wingate anaerobic cycling test between the active supplement phase and the placebo phase |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in physical function | 6 months | Change in physical function will be determined by the change in the hand grip strength, measured using a hand dynamometer. Three attempts will be given per hand, and the maximum grip strength achieved (in kg displaced) will be recorded for each hand. |
| Change in muscle fatigue | 6 months | Change in muscle fatigue will be determined by the change in the fatigue index during the wingate test. Fatigue index is a percentage, and is calculated as follows: \[(Peak Power - End Power)/Peak Power\] x100 |
| Change in general fatigue | 6 months | Change in fatigue will be determined by the change in the Pediatric Quality of Life - Fatigue Module scores (PedsQL-Fatigue). This measure is scored on a scale of 0-100 with 100 representing the least amount of fatigue. |
| Change in quality of life | 6 months | Change in quality of life will be determined by the change in the Quality of My Life questionnaire scores. Quality of my Life consists of 3 visual analog scales each scored out of 10. Higher scores indicate better quality of life. |
Countries
Canada
Outcome results
None listed