Oxandrolone in the Treatment of HIV-Associated Weight Loss in Men: A Randomized, Double-Blind, Placebo-Controlled Study

Grunfeld, Carl MD, PhD*; Kotler, Donald P. MD†; Dobs, Adrian MD‡; Glesby, Marshall MD§; Bhasin, Shalender MD∥; for the Oxandrolone Study Group

JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/01.qai.0000197546.56131.40
Clinical Science

Objective: To evaluate the efficacy and safety of oxandrolone in promoting body weight and body cell mass (BCM) gain in HIV-associated weight loss.

Methods: Randomized, double-blind, placebo-controlled trial. Two hundred sixty-two HIV-infected men with documented 10% to 20% weight loss or body mass index ≤20 kg/m2 were randomized to placebo or to 20, 40, or 80 mg of oxandrolone daily. After 12 weeks, subjects were allowed to receive open-label oxandrolone at a dose of 20 mg for another 12 weeks.

Results: Body weight increased in all groups, including the group receiving placebo, during the double-blind phase (1.1 ± 2.7, 1.8 ± 3.9, 2.8 ± 3.3, and 2.3 ± 2.9 kg in placebo and 20-, 40-, and 80-mg oxandrolone groups, respectively; all P < 0.014 vs. baseline). BCM increased from baseline in all groups (0.45 ± 1.7, 0.91 ± 2.2, 1.5 ± 2.5, and 1.8 ± 1.8 kg in placebo and 20-, 40-, and 80-mg oxandrolone groups, respectively). At 12 weeks, only the gain in weight at the 40-mg dose of oxandrolone and the gain in BCM at the 40- and 80-mg doses of oxandrolone were greater than those in the placebo group, however. Oxandrolone treatment was associated with significant suppression of sex hormone-binding globulin, luteinizing hormone, follicle-stimulating hormone, and total and free testosterone levels. Treatment was generally well tolerated but accompanied by significant increases in transaminases and low-density lipoprotein as well as decreases in high-density lipoprotein.

Conclusion: Oxandrolone administration is effective in promoting dose-dependent gains in body weight and BCM in HIV-infected men with weight loss.

Author Information

From the *University of California, San Francisco, and the Department of Veterans Affairs Medical Center, San Francisco, CA; †St. Lukes- Roosevelt Medical Center, Columbia University School of Medicine, New York, NY; ‡Johns Hopkins School of Medicine, Baltimore, MD; §Community Research Initiative on AIDS, New York, NY and ∥Charles Drew University of Medicine and Science, Los Angeles, CA.

Received August 3, 2005; accepted November 10, 2005

Grant support provided by Biotechnology General (now Savient Pharmaceuticals).

Reprints: Carl Grunfeld, Metabolism section (111F), Department of Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121 (e-mail: grunfld@itsa.ucsf.edu).

© 2006 Lippincott Williams & Wilkins, Inc.