Oxandrolone no better than placebo for severe pressure ulcers

Ann Intern Med2013;158:718-26OpenUrlCrossRefPubMed

Anabolic steroids are thought to promote wound healing and can be used to treat some severe burns. Oxandrolone, however, did nothing for chronic pressure ulcers in a trial of US veterans with longstanding spinal injuries. Participants given the steroid were no more likely to heal over 24 weeks than controls given a matching placebo (24.1% (26/108), 95% CI, 16.0% to 32.1% v 29.8% (31/104 ) 21.0% to 38.6%). They all had standard care at one of 16 spinal injury centres run by the US Department of Veterans Affairs.

Participants, who were almost all men, had serious and hard to treat pressure ulcers in the sacral, ischial, or trochanteric regions. Nearly two thirds had full thickness ulcers. Oxandrolone didn’t seem to help these ulcers heal or prevent recurrence in the minority that did heal. Eight weeks after the end of treatment, 16.7% (18/108) of the oxandrolone group and 15.4% (16/104) of controls had a fully healed ulcer.

The results were a disappointment, and a data monitoring committee stopped the trial well before target recruitment. Oxandrolone caused significantly more abnormal liver function tests than placebo; it also caused significantly more anaemia, which the authors found harder to explain.