Supplemental glutamine of no benefit in patients with severe burns

Supplementation with glutamine in patients with severe burns falls short of reducing the time to discharge alive from the hospital, according to the results of the RE-ENERGIZE trial.

RE-ENERGIZE included 1,209 patients with deep second- or third-degree burns (affecting ≥10 to ≥20 percent of total body-surface area). They were randomized to receive 0.5 g of enterally delivered glutamine per kilogram of body weight per day or placebo within 72 hours after hospital admission. The mean burn size in the cohort was 33 percent of total body-surface area.

The study drugs were administered every 4 hours through a feeding tube or three or four times a day by mouth until 7 days after the last skin grafting procedure, discharge from the acute care unit, or 3 months after admission, whichever came first.

Of the randomized patients, 1,200 were included in the analysis, including 596 patients in the glutamine group and 604 in the placebo group. The primary endpoint of median time to discharge alive from the hospital was 40 days (interquartile range, 24 to 87) in the glutamine group and 38 days (interquartile range, 22 to 75) in the placebo group. The difference was not statistically significant (subdistribution hazard ratio, 0.91, 95 percent confidence interval [CI], 0.80–1.04; p=0.17).

Likewise, there was no substantial between-group difference in mortality at 6 months (17.2 percent in the glutamine group vs 16.2 percent in the placebo group; hazard ratio, 1.06, 95 percent CI, 0.80–1.41).

The frequency of serious adverse events was similar in the two groups.