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The full report is titled “The Effect of Oxandrolone on the Healing of Chronic Pressure Ulcers
in Persons With Spinal Cord Injury. A Randomized Trial.” It is in the 21 May 2013 issue of
Annals of Internal Medicine (volume 158, pages 718-726). The authors are W.A. Bauman,
A.M. Spungen, J.F. Collins, D.W. Raisch, C. Ho, G.A. Deitrick, B.A. Nemchausky, L.L. Goetz, J.S. Park,
M. Schwartz, J.L. Merritt, V. Jayawardena, P. Sandford, S. Sabharwal, S.A. Holmes, F. Nasar, R.
Sasaki, V. Punj, K.F. Zachow, W.C. Chua, M.D. Thomas, and R.C. Trincher
Oxandrolone Treatment for Pressure Ulcers. Ann Intern Med. 2013;158:I-20. doi: 10.7326/0003-4819-158-10-201305210-00002
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Published: Ann Intern Med. 2013;158(10):I-20.
Pressure ulcers are a common medical problem among people confined to a wheelchair or bed for long periods.
Also known as bedsores, they occur when prolonged pressure reduces blood flow to an area, injuring the skin
and underlying tissues. The resulting ulcers can be painful and difficult to treat; if they do not heal,
they can lead to serious complications, including death. Anabolic steroids, such as oxandrolone, have shown
promise in healing chronic pressure ulcers; however, research on their use is limited.
To learn whether oxandrolone helps to heal severe pressure ulcers.
779 veterans with spinal cord injury and severe pressure ulcers of the pelvic region (such as the tailbone
Between August 2005 and November 2008, researchers enrolled patients from 16 Veterans Affairs medical
centers. There was a screening phase and a treatment phase. During the screening phase, patients received
standard medical care, including wound care, debridement, and pressure relief of the ulcer. Doctors could
also use extra treatments, such as ultraviolet light, laser therapy, hyperbaric oxygen, and electrical
stimulation. After 4 weeks, 108 patients with pressure ulcers that had not healed were randomly assigned to
receive 20 mg of oxandrolone daily and 104 were randomly assigned to receive placebo. Patients remained in
treatment until their ulcer had fully healed or for 24 weeks, whichever occurred first. The researchers also
followed patients whose ulcers healed to determine whether they stayed healed.
Forty-three patients assigned to receive oxandrolone and 37 assigned to receive placebo did not complete
treatment. Of those who completed treatment, pressure ulcers healed in 24% of the oxandrolone group and 30%
of the placebo group. Ulcers remained healed in 17% of those who received oxandrolone versus 15% of those
who received placebo. Use of oxandrolone was not associated with any serious adverse events.
Approximately one third of the patients did not complete treatment.
Oxandrolone did not seem to improve healing of severe pressure ulcers, nor did it help to keep the ulcers
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