Abstract Number: Esoc2026ot29 Effect of Creatine Monohydrate Supplementation on Recovery After Ischemic Stroke: The Sucre Clinical Trial

Background and aims Ischemic stroke is a leading cause of disability worldwide. Despite recent advances in acute care, post-stroke interventions remain suboptimal, especially those targeting physical and functional recovery. Motor symptoms produce profound functional limitations, stemming from muscle weakness that triggers atrophy, impaired balance, among other symptoms, all culminating in reduced daily physical activity that perpetuates sarcopenia and functional decline, all worsened by hospitalization. Sarcopenia, fueled by systemic inflammation, poor nutrition, and immobility among other factors, holds critical prognostic implications for long-term functional outcomes. Creatine monohydrate, a nutritional supplement with a well-established safety profile, has demonstrated benefits in muscle strength, energy metabolism, and neuroprotection, yet its role in post-stroke recovery is still underexplored. Methods To evaluate the efficacy and safety of creatine monohydrate supplementation in improving recovery after a recent ischemic stroke. Results This is an ongoing single-center, randomized, double-blind, placebo-controlled pilot trial. Ninety-two adult patients with ischemic stroke (24 hours to 7 days post-onset) and motor deficits requiring rehabilitation will be randomized 1:1 to receive either creatine monohydrate (0.3 g/kg/day for 7 days, followed by 0.1 g/kg/day for 12 weeks) or matching placebo, alongside standard rehabilitation and care. Conclusions The primary outcome is improvement in the 6-minute walk test at 12 and 24 weeks. Secondary outcomes include muscle strength, balance (PASS), disability (mRS, Barthel), quality of life (EQ-5D-5L), cognition (MoCA), mood (HADS) and nutritional status (DXA, bioimpedance). Safety is assessed via adverse events and laboratory monitoring. Conflict of interest