Adjuvant anabolic agents: A case report on the successful use of oxandrolone in an HIV-positive patient with chronic stasis ulceration

Cioroiu, Michael; Hanan, Scott H.

doi:10.1067/mjw.2001.116252

Journal of WOCN

2001

DOI: 10.1067/mjw.2001.116252

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Adjuvant anabolic agents: A case report on the successful use of oxandrolone in an HIV-positive patient with chronic stasis ulceration

Michael Cioroiu

Scott H. Hanan

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“…The most significant rate of wound closure observed in these patients occurred after 50% of lost weight was restored. The use of oxandrolone to successfully treat chronic stasis ulceration in an HIV + man has also been reported[58]. Although clinical case studies have limited usefulness in determining the effectiveness of drug therapy, these observations of weight gain and improved healing with oxandrolone are encouraging.…”

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Protein-energy malnutrition and involuntary weight loss: nutritional and pharmacological strategies to enhance wound healing

Collins¹

2003

Expert Opinion on Pharmacotherapy

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Clinically significant involuntary weight loss (IWL) is defined as a loss of 4.5 kg or > 5% of the usual body weight over a period of 6 - 12 months, especially when progressive. Weight loss of > 10% of normal body weight is considered to represent protein-energy malnutrition (PEM). Despite progress in our understanding of the aetiology and pathophysiology of IWL and PEM, these conditions remain frequent and serious problems in several high-risk populations in both acute and long-term care facilities. In patients with IWL and PEM, nonhealing wounds signal a catabolic process that requires prompt nutritional intervention. Aggressive nutritional therapy that provides adequate protein, calories and micronutrients, combined with an anabolic agent such as oxandrolone, may provide the most optimal environment for restoration of lean body mass and body weight and in turn, promote wound healing. More research, however, is needed to define optimal nutritional and anabolic therapies for these patients given the associated high morbidity and cost of care.

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Protein-energy malnutrition and involuntary weight loss: nutritional and pharmacological strategies to enhance wound healing

Collins¹

2003

Expert Opinion on Pharmacotherapy

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The Anabolic Androgenic Steroid Oxandrolone in the Treatment of Wasting and Catabolic Disorders

Orr

2004

Drugs

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There has been increasing interest in the development of effective agents that can be safely used to promote anabolism in the clinical setting for patients with chronic wasting conditions as well as in the prevention and treatment of frailty associated with loss of muscle tissue in aging (sarcopenia). One such agent is the anabolic androgenic steroid (AAS) oxandrolone, which has been used in such clinical situations as HIV-related muscle wasting, severe burn injury, trauma following major surgery, neuromuscular disorders and alcoholic hepatitis for over 30 years. In the US, oxandrolone is the only AAS that is US FDA-approved for restitution of weight loss after severe trauma, major surgery or infections, malnutrition due to alcoholic cirrhosis, and Duchenne's or Becker's muscular dystrophy. Our review of the use of oxandrolone in the treatment of catabolic disorders, HIV and AIDS-related wasting, neuromuscular and other disorders provides strong evidence of its clinical efficacy. Improvements in body composition, muscle strength and function, status of underlying disease or recovery from acute catabolic injury and nutritional status are significant in the vast majority of well designed trials. However, oxandrolone has not yet been studied in sarcopenia.Unlike other orally administered C17alpha-alkylated AASs, the novel chemical configuration of oxandrolone confers a resistance to liver metabolism as well as marked anabolic activity. In addition, oxandrolone appears not to exhibit the serious hepatotoxic effects (jaundice, cholestatic hepatitis, peliosis hepatis, hyperplasias and neoplasms) attributed to the C17alpha-alkylated AASs. Oxandrolone is reported to be generally well tolerated and the most commonly documented adverse effects are transient elevations in transaminase levels and reductions in high density lipoprotein cholesterol level.However, optimal risk:benefit ratios for oxandrolone and other agents in its class will need to be refined before widespread clinical acceptance of AASs as a therapeutic option in sarcopenia and other chronic wasting conditions.

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Adjuvant anabolic agents: A case report on the successful use of oxandrolone in an HIV-positive patient with chronic stasis ulceration

Cited by 2 publications

References 9 publications

Protein-energy malnutrition and involuntary weight loss: nutritional and pharmacological strategies to enhance wound healing

Protein-energy malnutrition and involuntary weight loss: nutritional and pharmacological strategies to enhance wound healing

The Anabolic Androgenic Steroid Oxandrolone in the Treatment of Wasting and Catabolic Disorders

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