A part for Anabolic Steroids in the...

A part for Anabolic Steroids in the Rehabilitation of Patients with COPD? A Double-Blind, Placebo-Controlled, Randomized Trial. Creutzberg EC Wouter EF Mostert R Pluymer RJ Schol AM. Reprinted with permission from Chest. 2003;124:1 733-1 742 ?©2003 American association of Chest Physicians.

Study Objectives: Skeletal muscle weakness commonly befalls in patients with COPD. Long-term use of systemic glucocorticosteroids further contributes to muscle weakness. Anabolic steroids could be an additional method of intervention to improve issue of pulmonary rehabilitation by increasing physiologic functioning, possibly mediated by the agency of increasing erythropoietic function. Patients and Methods: We randomly assigned 63 male patients with COPD to receive onward days 1, 15, 29, and 43 a hard IM injection of 50 mg of nandrolone decanoate (ND) [DecaDurabolin; NV Organon; Os The Netherlands] in 1 ml_ of arachis oil, or 1 mL of arachis oil alone (placebo) in a double-blind design. All patients participated in a standardized pulmonary rehabilitation program. issue measures were body composition at deuterium and bromide dilution, respiratory and peripheral muscle function, incremental exercise testing, and health status from the St. George's Respiratory Questionnaire. Results: Treatment with ND relative to placebo be the effected in higher increases in fat-free mass (FFM; mean, 17 kg [SD 25] v 03 kg [SD 19]; p = 001 5) owing to a rise in intracellular mass (mean, 18 kg [SD 31] v - 05 kg [SD 31]; p = 0002) Muscle function, exercise capacity, and health status improved in the one and the other groups to the same compass Only after ND were increases in erythropoietic parameters seen (erythropoietin: mean, 208 U/L [SD 556] p = 0067; hemoglobin: mean, 029 mmol/L [SD 073] p = 0055) In the total clump the changes in maximal inspiratory chaps pressure (Plmax) and peak workload were positively correlated with the change in hemoglobin (r = 030 p = 0032 and r = 034 p = 0016 respectively), whereas the change in isokinetic leg work was correlated with the change in erythropoietin (r = 038 p = 0013) In the patients receiving maintenance treatment with low-dose oral glucocorticosteroids (31 of 63 patients; mean, 75 mg/24 h [SD 24]) greater improvements in Plmax (mean, 60 cm H(2)O [SD 882] v - 218 cm H(2)O [SD 1108] p = 0046) and peak workload (mean, 2047 W [SD 1982] v 480 W [SD 774] p = 0023) were seen after 8 weeks of treatment with ND v placebo. Conclusions: In conclusion, a short-term course of ND had an overall positive drift relative to placebo on FFM without expanding extracellular water in patients with COPD In the total cluster the improvements in muscle function and exercise capacity were associated with improvements in erythropoietic parameters. The use of low-dose oral glucocorticosteroids as maintenance medication significantly impaired the reply to pulmonary rehabilitation with heed to respiratory muscle function and exercise capacity, which could be restored by dint of ND treatment.

Copyright Cardiopulmonary Physical Therapy Journal Mar 2004

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