Patients with severe
chronic obstructive pulmonary disease (
COPD) commonly develop
weight loss, muscle wasting, and consequently poor survival. Nutritional supplementation and
anabolic steroids increase lean body mass, improve muscle strength, and survival in patients enrolled in comprehensive rehabilitation programs. Whether
anabolic steroids are effective outside an intensive rehabilitation program is not known. We conducted a prospective, double-blind, placebo-controlled, 16-week trial to study the benefits of
anabolic steroids in patients with severe
COPD who did not participate in a structured rehabilitation program. Biweekly
intramuscular injections of either the
drug (
nandrolone decanoate) or placebo were administered. Sixteen patients with severe
COPD were randomized to either placebo or
nandrolone decanoate. The placebo group weighed 55.32 +/- 11.33 kg at baseline and 54.15 +/- 10.80 kg at 16 weeks; the treatment group weighed 68.80 +/- 6.58 at baseline and 67.92 +/- 6.73 at 16 weeks. Lean body mass remained unchanged, 71 +/- 6 vs. 71 +/- 7 kg in placebo group and 67 +/- 7 vs. 67 +/- 7 in treatment group, at baseline and 16 weeks respectively. The distance walked on 6 min was unchanged at baseline, 8 weeks, and 16 weeks in placebo (291.17 +/- 134.83, 282.42 +/- 115.39, 286.00 +/- 82.63 m) and treatment groups (336.13 +/- 127.59, 364.83 +/- 146.99, 327.00 +/- 173.73 m). No improvement occurred in forced expiratory volume in one second, forced vital capacity, maximal inspiratory pressure, maximal expiratory pressure, VO(2) max or 6-min walk distance or health related quality of life. Administration of
anabolic steroids (
nandrolone decanoate) outside a dedicated rehabilitation program did not lead to either
weight gain, improvement in physiological function, or better quality of life in patients with severe
COPD.