Effects of Treatment with Oxandrolone for 4 Years on the Frequency of Severe Arithmetic Learning Disability in Girls with Turner Syndrome

Objectives To study androgen treatment effects on arithmetic performance in girls with Turner syndrome. Study design Forty-four girls, ages 10 to 14 years at baseline, completed 4 years of treatment with oxandrolone (Ox) or placebo (PI). All received growth hormone and estrogen replacement therapy. We assessed the number of girls with severe learning disability (LD, standard score <= 5(th) percentile) on measures of academic arithmetic and reading achievement (WRAT-3, arithmetic and reading), given yearly, and the WIAT numerical operations (NOS) and reading subtests, given at year 4. Results On the WRAT-3 arithmetic, the frequency of severe arithmetic LD was similar in the Ox and PI groups at baseline and at years 1 and 2. At years 3 and 4, fewer girls in the Ox than PI group had a severe arithmetic LD (year 4: 0/22 vs 5/21, P = .02). On the WIAT NOS (year 4), fewer girls in the Ox than PI groups had a severe arithmetic LD (3/21 vs 8/20, P = .09). WIAT NOS error analysis suggested that the improved performance in the Ox group was associated with better performance on multiplication and division (P < .01). The frequency of severe LD for the WRAT-3 reading was similar for the Ox and PI groups (all years) and for the WIAT reading subtest (year 4). Conclusions Androgen treatment for 4 years in girls with Turner syndrome resulted in a small decrease in frequency of severe arithmetic LD, with no effect on reading LD. (J Pediatr 2009; 155: 714-20).