Am. Spungen et al., Treatment with an anabolic agent is associated with improvement in respiratory function in persons with tetraplegia: A pilot study, MT SINAI J, 66(3), 1999, pp. 201-205
Background: Pulmonary complications are a major cause of morbidity and mort
ality among individuals with cervical spinal cord lesions. Strengthening of
the respiratory musculature may reduce these complications. Anabolic stero
ids have been used to increase muscle mass and improve muscle performance.
Oxandrolone, an anabolic steroid, may have beneficial effects on breathing
in persons with tetraplegia.
Methods: The effect of one-month treatment with oxandrolone on weight gain
and pulmonary function was studied in ten subjects with complete motor tetr
aplegia. Spirometry, maximal inspiratory and expiratory pressures, and rest
ing self-rating of dyspnea (Borg Scale) were measured at baseline and repea
ted again at the end of one month of oxandrolone therapy (20 mg/day). Serum
lipid profiles and liver function tests were performed before and after tr
eatment. A paired t-test was used to determine pre- and post-treatment diff
erences on the dependent variables. Percent change from baseline was calcul
ated for each variable and tested using a one-sample t-test.
Results: On average, the subjects gained 1.4+/-1.5 kg, a 2+/-2 increase in
weight(p=0.01). A significant, 9+/-2% improvement was found in the combined
measures of spirometry (p<0.005). Maximal inspiratory pressure improved an
average of 10+/-7% (p<0.001). Maximal expiratory pressure improved 9+/-13%
(non-significant). Subjective self-rating of dyspnea decreased an average
of 37+/-28% (p<0.01).
Conclusions: In healthy subjects with tetraplegia, the use of oxandrolone w
as associated with significant improvements in weight and pulmonary functio
n, and a subjective reduction in breathlessness. Therefore, oxandrolone may
be indicated to strengthen respiratory musculature in individuals who have
tetraplegia and ventilatory insufficiency aggravated by superimposition of
pneumonia or other such conditions. However, long-term use of oxandrolone
may not be indicated, due to the adverse complications associated with this
class of agents.