Anabolic-androgenic steroids for patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

Abstract

BackgroundTestosterone deficiency is common in chronic obstructive pulmonary disease (COPD) patients. There has been a growing interest in the potential use of anabolic-androgenic steroids (AASs) in patients with COPD recently. However, whether AASs could improve their clinical outcomes remains unknown.MethodsIn order to explore the efficacy of AASs in patients with COPD, systematic search of MEDLINE, Embase, the Cochrane Library and ClinicalTrials.gov for randomized controlled trials (RCTs) of AASs for COPD published before March 17, 2022 was performed.ResultsData were extracted from 8 articles involving 520 participants. The median number of participants per study was 39.5 and the mean follow up was 14.2 weeks. As compared to the control group, AASs therapy could significantly improve body weight (weighted mean difference (WMD), 1.38 kg; 95% CI, 0.79 to 1.97 kg), fat-free mass (WMD, 1.56 kg; 95% CI, 0.94 to 2.18 kg) and peak workload (WMD, 6.89W; 95% CI, 3.97 to 9.81W) of COPD patients, but no improvements in spirometry indicators and six-minute walking distances (WMD, 16.88 m; 95%, −3.27 to 37.04 m). Based on the available research data, it is uncertain whether AASs treatment could improve the quality of life of COPD patients.ConclusionsLimited published evidence indicates that AASs therapy provides clinical benefits in patients with COPD. However, longer and larger studies are needed to better clarify the efficacy of AASs and draw final conclusions.

Efficacy of interventions to alter measures of fat-free mass in people with COPD: a systematic review and meta-analysis

“…Our findings relating to increasing fat-free mass measures with anabolic steroids (specifically testosterone enanthate and nandrolone decanoate) in COPD support the results of studies in healthy adults (127) and people with diseases such as chronic renal failure, muscular dystrophy, and human immunodeficiency virus (128) as well as recent evidence in people with COPD (129,130). Substantial heterogeneity was observed in our findings suggesting a wide range of effects.…”

Systematic reviews and meta-analyses on androgen administration in humans: an umbrella review

“…Of the 19 included SRMA, one was on the illicit market for androgens [7 ▪▪ ], three were prevalence studies [4 ▪▪ ,8 ▪ ,9 ▪ ], three were on psychological side effects of androgen abuse in nonclinical settings [10 ▪▪ ,11 ▪ ,12 ▪ ], and 12 were on clinical/therapeutic uses of androgens [13–21,22 ▪ ,23,24]. Most of the studies on the topic of androgens in the recent years (2021–2023) have been conducted in North America, Europe, and Oceania, respectively, with few of them conducted in Asia and Middle East.…”

“…Three SRMA focused on the effect of androgen therapy on preventing skeletal muscle mass loss and improving physical functionality among patients with various disorders such as chronic obstructive pulmonary disease (COPD), heart failure, and cancer [15,16,22 ▪ ]. Correa et al [15] and Falqueto et al [16] conducted SRMA based on 17 and 27 studies, respectively, with various disorders and found an increase in lean muscle mass and/or muscle strength after androgen therapy.…”

“…With accumulating empirical research on androgens since the 1970s, several researchers have conducted systematic reviews and meta-analyses (SRMA) regarding various aspects of androgens, including their prevalence, correlates, outcomes, content, and market. Umbrella reviews are at the echelon of the research synthesis hierarchy and present an aerial view of research findings on a topic Of the 19 included SRMA, one was on the illicit market for androgens [ & ], and 12 were on clinical/therapeutic uses of androgens [13][14][15][16][17][18][19][20][21]22 & , 23,24]. Most of the studies on the topic of androgens in the recent years (2021-2023) have been conducted in North America, Europe, and Oceania, respectively, with few of them conducted in Asia and Middle East.…”

“…Continued) Correa et al[15] and Falqueto et al[16] conducted SRMA based on 17 and 27 studies, respectively, with various disorders and found an increase in lean muscle mass and/or muscle strength after androgen therapy. Finally, Liu et al[22 …”