Feasibility and preliminary effect of anabolic steroids in addition to strength training and nutritional supplement in rehabilitation of patients with hip fracture: a randomized controlled pilot trial (HIP-SAP1 trial).

[{"label":"BACKGROUND","text":"Anabolic steroid has been suggested as a supplement during hip fracture rehabilitation and a Cochrane Review recommended further trials. The aim was to determine feasibility and preliminary effect of a 12-week intervention consisting of anabolic steroid in addition to physiotherapy and nutritional supplement on knee-extension strength and function after hip fracture surgery."},{"label":"METHODS","text":"Patients were randomized (1:1) during acute care to: 1. Anabolic steroid (Nandrolone Decanoate) or 2. Placebo (Saline). Both groups received identical physiotherapy (with strength training) and a nutritional supplement. Primary outcome was change in maximal isometric knee-extension strength from the week after surgery to 14\u2009weeks. Secondary outcomes were physical performance, patient reported outcomes and body composition."},{"label":"RESULTS","text":"Seven hundred seventeen patients were screened, and 23 randomised (mean age 73.4\u2009years, 78% women). Target sample size was 48. Main limitations for inclusion were \"not home-dwelling\" (18%) and \"cognitive dysfunction\" (16%). Among eligible patients, the main reason for declining participation was \"Overwhelmed and stressed by situation\" (37%). Adherence to interventions was: Anabolic steroid 87%, exercise 91% and nutrition 61%. Addition of anabolic steroid showed a non-significant between-group difference in knee-extension strength in the fractured leg of 0.11 (95%CI -0.25;0.48) Nm\/kg in favor of the anabolic group. Correspondingly, a non-significant between-group difference of 0.16 (95%CI -0.05;0.36) Nm\/Kg was seen for the non-fractured leg. No significant between-group differences were identified for the secondary outcomes. Eighteen adverse reactions were identified (anabolic\u2009=\u200910, control\u2009=\u20098)."},{"label":"CONCLUSIONS","text":"Early inclusion after hip fracture surgery to this trial seemed non-feasible, primarily due to slow recruitment. Although inconclusive, positive tendencies were seen for the addition of anabolic steroid."},{"label":"TRIAL REGISTRATION","text":"Clinicaltrials.gov NCT03545347 ."}]