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Effects of long-term oxandrolone administration in severely burned children
Kevin D Murphy1, Suchmor Thomas, Ronald P Mlcak
1Department of Surgery, The University of Texas Medical Branch, Shriners Hospitals for Children, Galveston, TX 77550, USA.
Insights
Oxandrolone treatment for one year improved lean body mass, bone mineral content, and bone mineral density in children with severe burns. This anabolic therapy safely counteracted muscle and bone loss, aiding rehabilitation.
Area of Science:
- Pediatric critical care
- Burn rehabilitation
- Anabolic therapy
Background:
- Severe burns trigger muscle protein breakdown and impair bone formation, hindering recovery.
- Hypermetabolism post-burn exacerbates these catabolic effects.
- Weakness and growth disturbances complicate rehabilitation in pediatric burn survivors.
Purpose of the Study:
- To evaluate the efficacy of long-term oxandrolone administration in reversing muscle and bone catabolism.
- To assess the impact of oxandrolone on rehabilitation in pediatric burn patients.
- To determine if oxandrolone improves lean body mass and bone deposition after severe burns.
Main Methods:
- Randomized controlled trial involving pediatric patients with >40% total body surface area burns.
- Oxandrolone (0.1 mg/kg twice daily) or placebo administered for one year post-burn.
- Assessment of lean body mass (LBM), bone mineral content (BMC), and bone mineral density (BMD) via dual energy x-ray absorptiometry at multiple time points.
Main Results:
- Oxandrolone significantly increased LBM at 6, 9, and 12 months post-burn (P < .001).
- Bone mineral content (BMC) was significantly higher in the oxandrolone group at 12 months (P < .016).
- Improved age- and gender-matched BMD z scores were observed with oxandrolone treatment (P < .039), with unaffected liver transaminases.
Conclusions:
- Long-term oxandrolone therapy is safe and effective in improving LBM, BMC, and BMD in severely burned children.
- Oxandrolone administration aids in reversing catabolism and supports bone growth.
- This anabolic approach facilitates improved outcomes in pediatric burn rehabilitation.
Background:
Severe burns cause exaggerated catabolism of muscle protein and inhibit bone deposition. Weakness and bony growth arrest interfere with rehabilitation. The purpose of this study was to determine whether oxandrolone administration for 1 year after the burn reverses muscle and bone catabolism in hypermetabolic pediatric burn patients.
Methods:
Children with burns greater than 40% total body surface area were enrolled into a randomized controlled trial to receive oxandrolone as a long-term anabolic agent. All patients received similar clinical care. Subjects were studied at discharge (95% healed) and at 6, 9, and 12 months after the burn, after treatment with 0.1 mg/kg po bid or placebo. Serum hepatic transaminases were measured. Lean body mass (LBM), bone mineral content (BMC,) and bone mineral density (BMD) were measured by dual energy x-ray absorptiometry. Patients completed a safety questionnaire and were reviewed clinically at intervals.
Results:
The groups were similar in age, weight, and total body surface area burned. LBM was significantly greater with oxandrolone at 6, 9, and 12 months after the burn (P < .001) and BMC at 12 months (P < .016). Age- and gender-matched BMD z scores were significantly better with oxandrolone (P < .039). Liver transaminases were unaffected.
Conclusions:
Long-term administration of oxandrolone safely improves LBM, BMC, and BMD in severely burned children.
