Metabolic and hormonal changes of severely burned children receiving long-term oxandrolone treatment.
OBJECTIVE
When given to children for 1 year after a severe burn, oxandrolone significantly improves lean body mass, bone mineral content, and muscle strength. The beneficial effects of oxandrolone on height and weight were observed 1 year after treatment was discontinued. To study the efficacy of oxandrolone in severely burned children for 12 months after burn and 12 months after the drug was discontinued.


BACKGROUND
Oxandrolone attenuates body catabolism during the acute phase after burn. It is unclear whether oxandrolone would have any beneficial effects during long-term treatment or if there were any effects after the drug was stopped.


METHODS
Sixty-one children with 40% total body surface area burns were enrolled in this study. Patients were randomized into those to receive oxandrolone (n = 30) or placebo (n = 31) for the first 12 months. Treatment was discontinued after 12 months, and the patients were studied without the drug for the following 12 months. At discharge and 6, 12, 18, and 24 months after burn, height, weight, body composition, resting energy expenditure, muscle strength, and serum human growth hormone, insulin-like growth factor-I (IGF-1), IGF binding protein-3, insulin, cortisol, parathyroid hormone, tri-iodothyronine uptake (T3 uptake), and free thyroxine index (FTI) were measured. Statistical analysis used Tukey multiple comparison test. Significance was accepted at P < 0.05.


RESULTS
Oxandrolone improved lean body mass, bone mineral content and muscle strength compared with controls during treatment, P < 0.05. Serum IGF-1, T3 uptake, and FTI were significantly higher during drug treatment compared with controls, P < 0.05. Significant increases in height and weight with oxandrolone were observed after the end of treatment.


CONCLUSIONS
Oxandrolone improved body composition and strength in severely burned children during the 12 months of treatment. Its effect on height and weight continued after treatment was discontinued.
Przkora
Rene
R
Department of Surgery, University of Texas Medical Branch, Shriners Hospitals for Children, Galveston, TX 77550, USA.
Jeschke
Marc G
MG
Barrow
Robert E
RE
Suman
Oscar E
OE
Meyer
Walter J
WJ
Finnerty
Celeste C
CC
Sanford
Arthur P
AP
Lee
Jong
J
Chinkes
David L
DL
Mlcak
Ronald P
RP
Herndon
David N
DN
D000293:Adolescent; D045930:Anabolic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015992:Body Mass Index; D049628:Body Size / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D002056:Burns / Q000150:complications / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology / Q000517:prevention & control; D018482:Muscle, Skeletal / Q000187:drug effects / Q000502:physiology; D010074:Oxandrolone / Q000494:pharmacology* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D045930:Anabolic Agents; D010074:Oxandrolone