Nandrolone effective for treating HIV wasting in specific patients
About 90% of the patients completed the 12 weeks but only half completed 24 weeks.
Additional improvements
[Your Turn]

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May 1999

CANNES, France - Anabolic steroids - when administered to patients with wasting syndrome associated with HIV infection - don't cause dangerous mood swings or decrease sexual functioning as have been observed with other uses.

In fact, the first randomized, placebo-controlled trial of the steroid nandrolone decanoate (Deca-Durabolin, Organon) in AIDS wasting syndrome actually improved some facets of patients' mental conditions and improved sexual functioning.

Julian Gold, MD, director of the Albion Street Clinic and chairman of the department of clinical epidemiology at the Prince of Wales Hospital, Sydney, Australia, reported the results of clinical trials conducted in Brazil and Thailand at the 3rd International Conference on HIV Infection and Nutrition recently held here.

In addition, Gold said, "What we see in this first randomized, placebo-controlled, dose ranging trial of nandrolone decanoate was a very clear improvement in the parameters of nutrition."

However, patients using the steroid must have CD4 counts of more than 50, based on the study results.

Gold said publicity about use of steroids during the 1988 Olympics piqued his interest in using steroid among HIV-infected patients who were losing weight and didn't seem to have an underlying opportunistic infection.

"We decided to use nandrolone decanoate because it is injected; it can be given quite infrequently - perhaps once a week or once every two weeks; it has been used for well over four decades; it has very low toxicity and its method of action is very well known," Gold said.

"We had noticed that when we gave this to about 50 patients who were losing weight, their weight stabilized," he said.

In the study conducted among HIV-positive men in Thailand and Brazil, researchers enrolled subjects who had lost 5% to 20% of body weight. The patients were randomized to either receive placebo, or 50 mg, 100 mg, 150 mg of nandrolone decanoate every two weeks for 24 weeks.

About 90% of the 90 patients completed 12 weeks; but only half completed 24 weeks. Gold said. "Essentially the reason for this is that nearly all of the patients who enrolled in Brazil and Thailand had a CD4 count less than 50 and they dropped out before week 24 because they developed serious opportunistic infections or died," he said.

"We observed that of those on 150 mg, there was a highly significant improvement in weight, in body mass index, in lean body mass and improvement in total body water which is a gauge of improvement in muscle," he said.

Additional improvements
Gold also found improvements in psychological and sexual functioning, compared with the patients' baseline scores on standard scales. "Those that used nandrolone decanoate over 16 weeks did not exacerbate their depression, anxiety or stress; nor did it cause depression, anxiety or stress in patients who weren't having problems at the start of the trial.

"We did find that patients with clinical stress at baseline improved their stress - they actually felt less stress," he said.

"Sexual functioning improved," he said, when researchers looked at sexual fulfillment, sexual enjoyment as well as sexual performance. He said a lot of that may have been due to the fact that because the men stopped losing weight, they looked better and felt better.

Gold said plans are under way for larger studies to find a role for the drug in AIDS patients and possibly in use in patients experiencing lipid dystrophies. Because the drug is relatively inexpensive, Gold said it might be useful in nations where health budgets are sharply limited.

For further information, contact Gold by e-mail, [email protected], or by fax, +61-29-332-4219.

For more information:

Gold J. Anabolic steroids in the management of HIV wasting. Session 7. 3rd International Conference on HIV infection and nutrition. April 22-25, 1999. Cannes, France.

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