Mount Sinai Journal of Medicine - Volume 66, Number 3, Page 201

Volume 66 Number 3
May 1999 back to contents

Treatment with an Anabolic Agent Is Associated with Improvement in
Respiratory Function in Persons with Tetraplegia: A Pilot Study 201 - 205

Ann M. Spungen, Ed.D.^1,2,3, David R. Grimm, Ed.D.2, Marianna Strakhan, B.S.¹,
Pia M. Pizzolato, M.S., R.D.4, and William A. Bauman, M.D.^1,5,6

From the ¹Spinal Cord Damage Research Center, ²Assistant Professor of Medicine and ³Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY; ⁴Nutrition and Food Program, Veterans Affairs Medical Center, Bronx, NY; ⁵Professor of Medicine and Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY; and ⁶Department of Medicine, Veterans Affairs Medical Center, Bronx, NY.
Work originated at Spinal Cord Damage Research Center, Mount Sinai School of Medicine, New York, NY; and Medicine and Spinal Cord Injury Services, Veterans Affairs Medical Center, Room 1E-02, 130 West Kingsbridge Road, Bronx, NY 10468 or address e-mail to: msjourn@doc.mssm.edu
Address correspondence to Dr. Ann M. Spungen, Spinal Cord Damage Research Center, Room 1E-02, Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468.

ABSTRACT
BACKGROUND: Pulmonary complications are a major cause of morbidity and mortality among individuals with cervical spinal cord lesions. Strengthening of the respiratory musculature may reduce these complications. Anabolic steroids 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 tetraplegia. Spirometry, maximal inspiratory and expiratory pressures, and resting self-rating of dyspnea (Borg Scale) were measured at baseline and repeated 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 treatment. A paired t-test was used to determine pre- and post-treatment differences on the dependent variables. Percent change from baseline was calculated 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 was associated with significant improvements in weight and pulmonary function, 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

KEY WORDS
Anabolic agent, oxandrolone, breathing, pulmonary function, tetraplegia, spinal cord injury

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