The Clinical Use of Anabolic Steroid Oxandrolone for Burn Patients: A Review

To reduce burn damage, especially in severe cases, pharmacological interventions aiming to decrease the intense catabolism such as the use of anabolic androgenic steroids (AAS) have been previously studied. Oxandrolone, an oral derived compound from DHT (dihydrotestosterone), is used since the 60s, was pharmacologically developed to promote a predominance of anabolic action over androgenic action and is also approved by regulatory entities for on-label use in severe weight loss diseases. However, several published studies present differences in their methodologies (e.g. interventional or observational), patients characteristics, oxandrolone doses, usage protocols, clinical outcomes and magnitudes of observed effects. Therefore, we conducted a structured systematic search, in main scientific databases, searching for systematic reviews and meta-analysis that summarized the potential efficacy and safety of oxandrolone use in burn patients. A structured systematic search was carried out using a combination of MeSH terms for oxandrolone and burn, filtered for systematic reviews, in PUBMED and CENTRAL database. As a conclusion to the results that we observed (reduction in weight loss and a higher rate of weight regain after burns, a reduction in muscle mass loss, an improvement in muscle nitrogen retention and protein balance, a reduction in the healing time of the donor site, a reduction in the length of hospital stay, an increase in muscle strength, bone mass, total weight gain and growth rate), the clinical oxandrolone use for burn patients can be considered an effective and clinically safe pharmacological intervention and, given the important morphological and metabolic benefits observed in short and long-term, it should be routinely considered as an adjuvant treatment to be added to standard care in burn patients.