Efficacy of Alternative Forms of Creatine Supplementation on Improving Performance and Body Composition in Healthy Subjects: A Systematic Review.
Level 1 - systematic review of randomized trials
Systematic review of randomized placebo-controlled trials
PubMed 36000773 · doi:10.1519/JSC.0000000000003873
What was done
Researchers conducted a systematic review following PRISMA guidelines across CENTRAL, PubMed, Medline, and Google Scholar to evaluate the ergogenic efficacy and body composition effects of novel creatine forms versus placebo or creatine monohydrate (CrM). Seventeen randomized, placebo-controlled trials were included, covering magnesium-creatine chelate, creatine citrate, malate, ethyl ester, nitrate, and pyruvate. A marketplace pricing analysis was also conducted.
What was found
Across the 17 included trials, there were no consistent improvements in exercise performance or body composition with alternative creatine formulations compared to placebo. Only 3 of the 17 studies directly compared an alternative form against creatine monohydrate, precluding robust head-to-head efficacy comparisons. Marketplace analysis confirmed that creatine monohydrate remains the lowest-cost option available.
Why it matters
Despite commercial marketing claiming superior bioavailability or performance benefits for novel creatine formulations, existing clinical data do not support their superiority or consistent efficacy over traditional, cheaper creatine monohydrate.
Limits
The abstract reports no pooled quantitative meta-analytic effect sizes or participant counts. Direct comparative evidence against standard creatine monohydrate was restricted to just 3 trials across all novel forms evaluated, limiting direct non-inferiority or superiority conclusions.