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Background <p>Burn injuries claim over 180,000 lives annually, often causing lasting discomfort, incapacity, and reduced quality of life. Severe burns trigger a hypermetabolic reaction with lean body loss and delayed wound healing. Oxandrolone, a synthetic testosterone analog, has shown promise in improving weight gain and nitrogen balance. This meta-analysis assessed its safety and effectiveness in severe burn cases.</p> Methods <p>In February 2024, a thorough search was conducted across six major databases to identify randomized controlled trials (RCTs) comparing oxandrolone with placebo or no treatment in patients with &gt; 20% TBSA burns. Key outcomes included heart rate, nitrogen loss, weight loss, lean body mass, metabolic rate, length of hospital stay, liver dysfunction, and mortality. Data were synthesized using a random-effects model, and the risk of bias was assessed with the Cochrane RoB 2.0 tool.</p> Results <p>Fifteen RCTs comprising 1,011 patients met the inclusion criteria. Oxandrolone use was associated with significant reductions in heart rate (SMD = -1.28; <i>P</i> = 0.003), nitrogen loss (SMD = -2.92; <i>P</i> &lt; 0.001), net weight loss (SMD = -1.88; <i>P</i> = 0.001), and length of hospital stay (SMD = -1.16; <i>P</i> = 0.009). However, no significant improvements were found in lean body mass, metabolic rate, liver function, or mortality.</p> Conclusions <p>Oxandrolone provides short-term improvements in catabolic markers and length of hospitalization in patients with severe burns. Additional rigorously designed studies are required to define its long-term safety, clinical durability, and potential alternatives. Level of Evidence: Level I, therapeutic study.</p>

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Oxandrolone for severe burn patients: a meta-analysis and systematic review of clinical trials

  • 期刊论文

  • 发表日期：

    2025年12月17日

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  • Rayan A. Alzahrani,
  • Ibrahim R. Halawani,
  • Saja M. Alghamdi,
  • Rawan M. Almoshawer,
  • Abdullah M. Alghamdi,
  • Zahra Ebrahim Alramel,
  • Abdulaziz B. Fathi,
  • Amna Alsayed Jaffar Majeed,
  • Mohammed Mousa Mohammed Alzahrani,
  • Aseel H. Askar,
  • Ezdehar Fallatah

摘要

Background

Burn injuries claim over 180,000 lives annually, often causing lasting discomfort, incapacity, and reduced quality of life. Severe burns trigger a hypermetabolic reaction with lean body loss and delayed wound healing. Oxandrolone, a synthetic testosterone analog, has shown promise in improving weight gain and nitrogen balance. This meta-analysis assessed its safety and effectiveness in severe burn cases.

Methods

In February 2024, a thorough search was conducted across six major databases to identify randomized controlled trials (RCTs) comparing oxandrolone with placebo or no treatment in patients with > 20% TBSA burns. Key outcomes included heart rate, nitrogen loss, weight loss, lean body mass, metabolic rate, length of hospital stay, liver dysfunction, and mortality. Data were synthesized using a random-effects model, and the risk of bias was assessed with the Cochrane RoB 2.0 tool.

Results

Fifteen RCTs comprising 1,011 patients met the inclusion criteria. Oxandrolone use was associated with significant reductions in heart rate (SMD = -1.28; P = 0.003), nitrogen loss (SMD = -2.92; P < 0.001), net weight loss (SMD = -1.88; P = 0.001), and length of hospital stay (SMD = -1.16; P = 0.009). However, no significant improvements were found in lean body mass, metabolic rate, liver function, or mortality.

Conclusions

Oxandrolone provides short-term improvements in catabolic markers and length of hospitalization in patients with severe burns. Additional rigorously designed studies are required to define its long-term safety, clinical durability, and potential alternatives. Level of Evidence: Level I, therapeutic study.