The effect of oxandrolone on the endocrinologic, inflammatory, and hypermetabolic responses during the acute phase postburn

Marc G. Jeschke, Celeste Finnerty, Oscar Suman, Gabriela Kulp, Ronald P. Mlcak, David Herndon

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

OBJECTIVE AND SUMMARY BACKGROUND DATA: Postburn long-term oxandrolone treatment improves hypermetabolism and body composition. The effects of oxandrolone on clinical outcome, body composition, endocrine system, and inflammation during the acute phase postburn in a large prospective randomized single-center trial have not been studied. METHODS: Burned children (n = 235) with >40% total body surface area burn were randomized (block randomization 4:1) to receive standard burn care (control, n = 190) or standard burn care plus oxandrolone for at least 7 days (oxandrolone 0.1 mg/kg body weight q.12 hours p.o, n = 45). Clinical parameters, body composition, serum hormones, and cytokine expression profiles were measured throughout acute hospitalization. Statistical analysis was performed by Student t test, or ANOVA followed by Bonferroni correction with significance accepted at P < 0.05. RESULTS: Demographics and clinical data were similar in both groups. Length of intensive care unit stay was significantly decreased in oxandrolone-treated patients (0.48 ± 0.02 days/% burn) compared with controls (0.56 ± 0.02 days/% burn), (P < 0.05). Control patients lost 8 ± 1% of their lean body mass (LBM), whereas oxandrolone-treated patients had preserved LBM (+9 ± 4%), P < 0.05. Oxandrolone significantly increased serum prealbumin, total protein, testosterone, and AST/ALT, whereas it significantly decreased α2-macroglobulin and complement C3, P < 0.05. Oxandrolone did not adversely affect the endocrine and inflammatory response as we found no significant differences in the hormone panels and cytokine expression profiles. CONCLUSIONS: In this large prospective, double-blinded, randomized single-center study, oxandrolone shortened length of acute hospital stay, maintained LBM, improved body composition and hepatic protein synthesis while having no adverse effects on the endocrine axis postburn, but was associated with an increase in AST and ALT.

Original languageEnglish (US)
Pages (from-to)351-360
Number of pages10
JournalAnnals of Surgery
Volume246
Issue number3
DOIs
StatePublished - Sep 2007

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Oxandrolone
Acute-Phase Reaction
Body Composition
Hormones
Cytokines
Macroglobulins
Complement C3
Endocrine System
Prealbumin
Body Surface Area
Random Allocation
Serum
Intensive Care Units
Testosterone
Length of Stay
Analysis of Variance
Proteins
Hospitalization
Body Weight
Demography

ASJC Scopus subject areas

  • Surgery

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The effect of oxandrolone on the endocrinologic, inflammatory, and hypermetabolic responses during the acute phase postburn. / Jeschke, Marc G.; Finnerty, Celeste; Suman, Oscar; Kulp, Gabriela; Mlcak, Ronald P.; Herndon, David.

In: Annals of Surgery, Vol. 246, No. 3, 09.2007, p. 351-360.

Research output: Contribution to journalArticle

Jeschke, Marc G. ; Finnerty, Celeste ; Suman, Oscar ; Kulp, Gabriela ; Mlcak, Ronald P. ; Herndon, David. / The effect of oxandrolone on the endocrinologic, inflammatory, and hypermetabolic responses during the acute phase postburn. In: Annals of Surgery. 2007 ; Vol. 246, No. 3. pp. 351-360.
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abstract = "OBJECTIVE AND SUMMARY BACKGROUND DATA: Postburn long-term oxandrolone treatment improves hypermetabolism and body composition. The effects of oxandrolone on clinical outcome, body composition, endocrine system, and inflammation during the acute phase postburn in a large prospective randomized single-center trial have not been studied. METHODS: Burned children (n = 235) with >40{\%} total body surface area burn were randomized (block randomization 4:1) to receive standard burn care (control, n = 190) or standard burn care plus oxandrolone for at least 7 days (oxandrolone 0.1 mg/kg body weight q.12 hours p.o, n = 45). Clinical parameters, body composition, serum hormones, and cytokine expression profiles were measured throughout acute hospitalization. Statistical analysis was performed by Student t test, or ANOVA followed by Bonferroni correction with significance accepted at P < 0.05. RESULTS: Demographics and clinical data were similar in both groups. Length of intensive care unit stay was significantly decreased in oxandrolone-treated patients (0.48 ± 0.02 days/{\%} burn) compared with controls (0.56 ± 0.02 days/{\%} burn), (P < 0.05). Control patients lost 8 ± 1{\%} of their lean body mass (LBM), whereas oxandrolone-treated patients had preserved LBM (+9 ± 4{\%}), P < 0.05. Oxandrolone significantly increased serum prealbumin, total protein, testosterone, and AST/ALT, whereas it significantly decreased α2-macroglobulin and complement C3, P < 0.05. Oxandrolone did not adversely affect the endocrine and inflammatory response as we found no significant differences in the hormone panels and cytokine expression profiles. CONCLUSIONS: In this large prospective, double-blinded, randomized single-center study, oxandrolone shortened length of acute hospital stay, maintained LBM, improved body composition and hepatic protein synthesis while having no adverse effects on the endocrine axis postburn, but was associated with an increase in AST and ALT.",
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AU - Mlcak, Ronald P.

AU - Herndon, David

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