14. Metabolic and Hormonal Changes Of Severely Burned Children Receiving Long-Term Oxandrolone Treatment
Rene Przkora, MD*, Marc G. Jeschke, MD, PhD*, Celeste C. Finnerty, PhD*, Arthur P. Sanford, MD*, David L. Chinkes, PhD*, Ron P. Mlcak, PhD*, David N. Herndon, MD
Shriners Burns Hospital for Children and University of Texas Medical Branch, Galveston, TX
Major trauma and burns are associated with whole body catabolism and hypermetabolism. Oxandrolone attenuates the hypermetabolic response during the acute phase after burn injury. The aim of the present study was to determine the effect of long-term oxandrolone treatment in massively burned children.
One hundred and sixty-two children with >40% total body surface area burn were enrolled in the study and followed for 24 months after injury. Patients were treated with placebo or oxandrolone (0.1 mg/kg body weight twice per day p.o.) for the first 12 months. Treatment was then stopped and patients received no treatment for the following year. At discharge, 6, 9, 12, 18, and 24 months after burn height, weight, body composition, resting energy expenditure, and serum hormones were measured. Statistics was performed by ANOVA followed by Tukey, with significance accepted at p<0.05.
Oxandrolone improved lean body mass, body weight, and height velocity compared to controls, p<0.05. The positive effect of oxandrolone on height velocity and body weight persevered over 24 months, p<0.05. Oxandrolone affected the respiratory quotient (RQ) towards glucose utilization, p<0.05. IGF-I, T3 uptake, and FTI serum levels were significantly higher in the oxandrolone group compared to the control group, p<0.05, while there were no differences for insulin, GH, cortisol, parathormone, and IGFBP-3.
Long-term therapy with oxandrolone exerts anabolic effects, improves fat and glucose metabolism, height velocity and weight, and attenuates hypermetabolism in severely burned children. Some of the positive effects observed with oxandrolone therapy persevere even after the drug treatment.