title: Reversal of Growth Arrest With the Combined Administration of Oxandrolone and Propranolol in Severely Burned Children.
abstract: BACKGROUND
  The hypercatabolic response in severely burned pediatric patients is associated with increased production of catecholamines and corticosteroids, decreased formation of testosterone, and reduced strength alongside growth arrest for up to 2 years after injury. We have previously shown that, in the pediatric burned population, the administration of the testosterone analog oxandrolone improves lean body mass accretion and bone mineral content and that the administration of the β1-, β2-adrenoceptor antagonist propranolol decreases cardiac work and resting energy expenditure while increasing peripheral lean mass. Here, we determined whether the combined administration of oxandrolone and propranolol has added benefit.
  
  
  METHODS
  In this prospective, randomized study of 612 burned children [52% ± 1% of total body surface area burned, ages 0.5-14 years (boys); ages 0.5-12 years (girls)], we compared controls to the individual administration of these drugs, and the combined administration of oxandrolone and propranolol at the same doses, for 1 year after burn. Data were recorded at discharge, 6 months, and 1 and 2 years after injury.
  
  
  RESULTS
  Combined use of oxandrolone and propranolol shortened the period of growth arrest by 84 days (P = 0.0125 vs control) and increased growth rate by 1.7 cm/yr (P = 0.0024 vs control).
  
  
  CONCLUSIONS
  Combined administration of oxandrolone and propranolol attenuates burn-induced growth arrest in pediatric burn patients. The present study is registered at clinicaltrials.gov: NCT00675714 and NCT00239668.
authors.affiliation: *Department of Surgery †Institute for Translational Sciences, University of Texas Medical Branch ‡Shriners Hospital for Children-Galveston, Galveston, TX §Division of Plastic Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria ¶Department of Orthopedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston ||Department of Surgery, Massachusetts General Hospital, Boston, MA **Sealy Center for Molecular Medicine ††Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston.
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.forename: Charles D
authors.initials: CD
authors.lastname: Voigt
authors.forename: Karel D
authors.initials: KD
authors.lastname: Capek
authors.forename: Paul
authors.initials: P
authors.lastname: Wurzer
authors.forename: Ashley
authors.initials: A
authors.lastname: Guillory
authors.forename: Andrea
authors.initials: A
authors.lastname: Kline
authors.forename: Clark R
authors.initials: CR
authors.lastname: Andersen
authors.forename: Gordon L
authors.initials: GL
authors.lastname: Klein
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Tompkins
authors.forename: Oscar E
authors.initials: OE
authors.lastname: Suman
authors.forename: Celeste C
authors.initials: CC
authors.lastname: Finnerty
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Meyer
authors.forename: Linda E
authors.initials: LE
authors.lastname: Sousse
mesh_terms: D000293:Adolescent; D002056:Burns / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D006128:Growth / Q000187:drug effects; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D010074:Oxandrolone / Q000008:administration & dosage*; D011433:Propranolol / Q000008:administration & dosage*; D011446:Prospective Studies; D013739:Testosterone / Q000031:analogs & derivatives
chemical_list: D013739:Testosterone; D010074:Oxandrolone; D011433:Propranolol