Testosterone replacement therapy lowers mortality, CV risk in secondary hypogonadism
AUSTIN, Texas — Testosterone replacement therapy may lower the risk for myocardial infarction, stroke and all-cause mortality in men with secondary hypogonadism.
“In men with secondary hypogonadism unrelated to overt hypothalamic/pituitary pathology, with a modest prevalence of prior cardiovascular disease, testosterone replacement therapy was associated with a 50% risk reduction of the composite outcome (myocardial infarction, stroke or all-cause mortality),” Kevin Pantalone, DO, ECNU, FACE, staff endocrinologist and director of clinical research in the department of endocrinology at Cleveland Clinic, told Endocrine Today.
Using data from an electronic health record in a large, integrated health care system, Pantalone and colleagues studied outcomes in 418 men with secondary hypogonadism exposed to testosterone replacement therapy (median age, 53.8 years) and 283 matched controls (median age, 54.9 years). The main outcomes of interest were MI, stroke and all-cause mortality after testosterone replacement therapy.
The prevalence of established CVD was 9.8% in the testosterone-replacement group compared with 12.7% in the control group.
Patients were followed for a median duration of 3.8 years in the testosterone-replacement group and 3.4 years in the control group. During that time, the event rate for the composite outcome of MI, stroke or all-cause mortality was 3.3% in the testosterone-replacement group vs. 6.4% in the control group (P = .06). The researchers concluded that testosterone replacement therapy reduced the odds of the combined CV endpoint (HR = 0.49; 95% CI, 0.24-0.99).
“Our study adds to the growing body of evidence suggesting [testosterone replacement therapy] may not be harmful in certain populations of hypogonadal men and may even afford a protective effect,” Pantalone said. “A prospective randomized controlled trial evaluating the effect of [testosterone replacement therapy] in men with secondary hypogonadism is needed to establish the safety of [testosterone] replacement therapy, particularly in men with established CVD or those at high CV risk.” – by Amber Cox
George J, et al. Abstract #906. Presented at: AACE Annual Scientific and Clinical Congress; May 3-7, 2017; Austin, Texas.
Disclosure: Pantalone reports no relevant financial disclosures.