|The Effect of Oxandrolone On the Endocrinologic, Inflammatory and Hypermetabolic Responses During the Acute Phase Postburn|
|Marc G. Jeschke*, David N. Herndon |
Shriners Burns Hospital for Children, Galveston, TX
|OBJECTIVE(S): Post burn long term Oxandrolone treatment improves hypermetabolism and body composition. The effect of Oxandrolone on clinical outcome, body composition, endocrine system, and inflammation during the acute phase postburn in a large prospective randomized single-center trial has not been studied.|
METHODS: Burned children (n=235) with >40% total body surface area burn (TBSA) were randomized (block randomization 4:1) to receive standard burn care (control, n=190) or standard burn care plus Oxandrolone (Oxandrolone 0.1 mg/kg body weight q.12 hours p.o, n=45). Clinical parameters, body composition, serum hormones, and cytokine expression profile were measured throughout acute hospitalization. Statistical analysis was performed by ANOVA followed by Bonferronis’ correction with significance accepted at p<0.05.
RESULTS: Demographics and clinical data were similar in both groups. Length of ICU stay was significantly decreased in Oxandrolone treated patients (0.49±0.03 days/% burn) compared to controls (0.57±0.02 days/% burn), (p<0.05). Control patients lost -22±3% of their lean body mass, while Oxandrolone treated patients had preserved lean body mass (+2±2%), p<0.05. Oxandrolone significantly increased serum pre-albumin, and AST/ALT, while it significantly decreased complement C3 and Apolipoprotein A1, p<0.05. Oxandrolone did not adversely affect the endocrine and inflammatory response as we found no significant differences in the hormone panel and cytokine expression profile.
CONCLUSIONS: In this large prospective, double-blinded, randomized single center study Oxandrolone shortened length of acute hospital stay, maintained lean body mass, improved body composition, and hepatic protein synthesis with no adverse-effects on the endocrine axis postburn, but was associated with a transient increase in AST and ALT.
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