Reversal of Growth Arrest with the Combined Administration of Oxandrolone and Propranolol in Severely Burned Children
Published Date:Sep 2016
Source:Ann Surg. 264(3):421-428.
Pubmed Central ID:PMC5167626
Funding:R01 HD049471/HD/NICHD NIH HHS/United States
R01 GM112936/GM/NIGMS NIH HHS/United States
U48 DP000043/DP/NCCDPHP CDC HHS/United States
R01 GM056687/GM/NIGMS NIH HHS/United States
P50 GM060338/GM/NIGMS NIH HHS/United States
T32 GM008256/GM/NIGMS NIH HHS/United States
UL1 TR001439/TR/NCATS NIH HHS/United States
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 post 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 adrenoreceptor 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.
In this prospective, randomized study of 612 burned children (52 ± 1% of total body surface area burned, ages 0.5–14 years [males]; ages 0.5–12 years [females]), 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 post burn. Data were recorded at discharge, 6 months, and 1 and 2 years post injury.
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/y (p=0.0024 vs. control).
Combined administration of oxandrolone and propranolol attenuates burn-induced growth arrest in pediatric burn patients. This study is registered at clinicaltrials.gov: NCT00675714 and NCT00239668. Growth Arrest and Growth Rate By Treatment GroupTreatmentLength of Growth Arrest(Days)Growth Rate(cm/y)Control280 ± 195.9 ± 0.2Oxandrolone217 ± 175.8 ± 0.3Propranolol242 ± 136.3 ± 0.2Oxandrolone + Propranolol196 ± 15*7.6 ± 0.5*Data presented as mean ± standard error.*p<0.05 vs. control.
Supporting Files:No Additional Files
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