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Oxandrolone in pediatric patients with severe thermal burn injury

James T Miller1, Imad F Btaiche

  • 1Department of Clinical, Social, and Administrative Sciences, College of Pharmacy, University of Michigan Hospitals and Health Centers, Ann Arbor, MI 48109, USA.

The Annals of Pharmacotherapy
|August 7, 2008
PubMed

Insights

Oxandrolone improves protein synthesis, muscle strength, and weight gain in pediatric burn patients. This anabolic steroid is safe for up to 12 months, but requires monitoring of liver function and sexual development.

Area of Science:

  • Pediatric Burn Management
  • Anabolic Steroid Therapy
  • Rehabilitative Medicine

Background:

  • Severe thermal burns in children lead to significant catabolism and muscle wasting.
  • Anabolic steroids, like oxandrolone, are explored to counteract these effects.
  • Optimizing recovery in pediatric burn patients is a critical clinical challenge.

Purpose of the Study:

  • To review the efficacy and safety of oxandrolone as an adjunct therapy for pediatric patients with severe thermal burn injuries.
  • To synthesize current evidence on oxandrolone's role in acute and long-term postburn recovery.
  • To identify key considerations for using oxandrolone in this vulnerable population.

Main Methods:

  • Systematic review of English-language articles from MEDLINE and Science Citation Index (1950-April 2008).
  • Inclusion criteria: studies evaluating oxandrolone efficacy and safety in pediatric patients (20% total body surface area).
  • Key search terms: oxandrolone, burn, children.

Main Results:

  • Oxandrolone (0.1 mg/kg twice daily) enhances protein synthesis, lean body mass, muscle strength, weight gain, and bone mineral content in pediatric burn patients.
  • Therapy improved visceral protein concentrations and muscle strength, particularly when combined with exercise during rehabilitation.
  • Oxandrolone is generally safe for up to 12 months, with mild, reversible increases in liver transaminases and sexual changes noted.
  • Data primarily stem from a single study center, and wound healing data in severely burned children are limited.

Conclusions:

  • Adjunct oxandrolone therapy demonstrates benefits in both acute and long-term recovery phases for severely burned pediatric patients.
  • Close monitoring of liver function, sexual development, and growth patterns is essential during oxandrolone treatment.
  • Further research is needed to address data limitations, particularly regarding wound healing in this population.
Abstract

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