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1563: OXANDROLONE-INDUCED HEPATIC TRANSAMINITIS IN SEVERELY BURNED PATIENTS A RISK FACTOR ANALYSIS

www.ccmjournal.org Critical Care Medicine • Volume 46 • Number 1 (Supplement) Learning Objectives: Oxandrolone has been shown in the severely burned to increase body mass, promote wound and skin graft healing, and restore body weight. The most common adverse effect of oxandrolone therapy, transaminitis, has a reported incidence of 5–15%. There is currently limited data in the literature to further describe the outcomes associated with transaminitis and how to proactively identify patients at risk. The purpose of this study was to determine the incidence of oxandrolone induced transaminitis and to identify patient risk factors for transaminitis. Methods: Single-center, retrospective risk factor analysis comparing patients with severe thermal burn injury (total body surface area (TBSA) > 10%) treated with oxandrolone therapy with and without development of transaminitis from December 1, 2011 to September 30, 2016. Transaminitis was defined as any aspartate aminotransferase (AST) or alanine aminotransferase (ALT) value > 100 mg/dL while on oxandrolone therapy. Patient demographics, past medical history, lab values, and burn characteristics were recorded. A multivariable logistic regression model was performed to identify independent risk factors for transaminitis. Results: Sixty-six patients were included with 56% of patients having a TBSA burn between 2140% and 23% with a TBSA > 41%. Transaminitis occurred in 28 (42%) of patients. Two of four patients rechallenged with oxandrolone after transaminitis resolution developed a secondary transaminitis. Although no independent factors were associated with transaminitis risk, patients with transaminitis were younger (42 vs. 50 years), had a larger burn injury (37 vs. 30% TBSA) and were more likely to be African American (25 vs 5%). The incidence of liver dysfunction was higher among patients who developed transaminitis (10.7 vs. 2.6%), although this did not reach statistical significance. Conclusions: Transaminitis occurred at a higher rate than previously reported in the literature. Further research is warranted to identify risk factors for developing oxandrolone induced transaminitis, and whether rechallenging after resolution is warranted.