Abstract
Recent data suggest an increased risk of cardiovascular events and mortality in men on testosterone therapy (TT). To date, there are no long-term, prospective studies to determine safety. In such cases, retrospective observational studies can be helpful. We examined our patient database to determine whether TT altered the risk of all-cause mortality in men. We queried our hormone database for all men with a serum testosterone level and then examined charts to determine testosterone status. In all, 509 men had charts available for review. We linked our patient records to the National Death Index to determine mortality. Of the 509 men who met inclusion criteria, 284 were on TT and 225 did not use testosterone. Age (mean 54 years) and follow-up time (mean 10 years) were similar for both groups. In all, 19 men died—10 (4.4%) men not on TT and 9 (3.2%) men on TT. After adjusting for age and year of evaluation, there was no significant difference in the risk of death based on TT (hazard ratio 0.92, 95% confidence interval 0.36–2.35, P=1.0). There appears to be no change in mortality risk overall for men utilizing long-term testosterone therapy.
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References
Shores MM, Matsumoto AM, Sloan KL, Kivlahan DR . Low serum testosterone and mortality in male veterans. Arch Intern Med 2006; 166: 1660–1665.
Khera M, Bhattacharya RK, Blick G, Kushner H, Nguyen D, Miner MM . The effect of testosterone supplementation on depression symptoms in hypogonadal men from the Testim Registry in the US (TRiUS). Aging Male 2011; 15: 14–21.
Khera M, Bhattacharya RK, Blick G, Kushner H, Nguyen D, Miner MM . Improved sexual function with testosterone replacement therapy in hypogonadal men: real-world data from the Testim Registry in the United States (TRiUS). J Sex Med 2011; 8: 3204–3213.
Bhasin S, Storer TW, Berman N, Yarasheski KE, Clevenger B, Phillips J et al. Testosterone replacement increases fat-free mass and muscle size in hypogonadal men. J Clin Endocrinol Metab 1997; 82: 407–413.
Bhattacharya RK, Khera M, Blick G, Kushner H, Nguyen D, Miner MM . Effect of 12 months of testosterone replacement therapy on metabolic syndrome components in hypogonadal men: data from the Testim Registry in the US (TRiUS). BMC Endocr Disord 2011; 11: 18.
Kenny AM, Kleppinger A, Annis K, Rathier M, Browner B, Judge JO et al. Effects of transdermal testosterone on bone and muscle in older men with low bioavailable testosterone levels, low bone mass, and physical frailty. J Am Geriatr Soc 2010; 58: 1134–1143.
Khera M, Bhattacharya RK, Blick G, Kushner H, Nguyen D, Miner MM . Changes in prostate specific antigen in hypogonadal men after 12 months of testosterone replacement therapy: support for the prostate saturation theory. J Urol 2011; 186: 1005–1011.
Basaria S, Coviello AD, Travison TG, Storer TW, Farwell WR, Jette AM et al. Adverse events associated with testosterone administration. N Engl J Med 2010; 363: 109–122.
Srinivas-Shankar U, Roberts SA, Connolly MJ, O'Connell MD, Adams JE, Oldham JA et al. Effects of testosterone on muscle strength, physical function, body composition, and quality of life in intermediate-frail and frail elderly men: a randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab 2010; 95: 639–650.
Shores MM, Smith NL, Forsberg CW, Anawalt BD, Matsumoto AM . Testosterone treatment and mortality in men with low testosterone levels. J Clin Endocrinol Metab 2012; 97: 2050–2058.
Vigen R, O'Donnell CI, Baron AE, Grunwald GK, Maddox TM, Bradley SM et al. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA 2013; 310: 1829–1836.
Finkle WD, Greenland S, Ridgeway GK, Adams JL, Frasco MA, Cook MB et al. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. PLoS One 2014; 9: e85805.
Khera M, Bhattacharya RK, Blick G, Kushner H, Nguyen D, Miner MM . The effect of testosterone supplementation on depression symptoms in hypogonadal men from the Testim Registry in the US (TRiUS). Aging Male 2012; 15: 14–21.
Shores MM, Kivlahan DR, Sadak TI, Li EJ, Matsumoto AM . A randomized, double-blind, placebo-controlled study of testosterone treatment in hypogonadal older men with subthreshold depression (dysthymia or minor depression). J Clin Psychiatry 2009; 70: 1009–1016.
Calof OM, Singh AB, Lee ML, Kenny AM, Urban RJ, Tenover JL et al. Adverse events associated with testosterone replacement in middle-aged and older men: a meta-analysis of randomized, placebo-controlled trials. J Gerontol A Biol Sci Med Sci 2005; 60: 1451–1457.
Fernandez-Balsells MM, Murad MH, Lane M, Lampropulos JF, Albuquerque F, Mullan RJ et al. Clinical review 1: Adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis. J Clin Endocrinol Metab 2010; 95: 2560–2575.
Lantz PM, House JS, Lepkowski JM, Williams DR, Mero RP, Chen J . Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA 1998; 279: 1703–1708.
Park RM . The healthy worker survivor effect and mortality at two automotive engine manufacturing plants. Am J Ind Med 1996; 30: 655–663.
Acknowledgements
This study is supported in part by P01HD36289 from the Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes of Health (to DJL and LIL). The project was also partially supported by an investigator-initiated grant from Endo Pharmaceuticals (to MLE and LIL).
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Dr Lipshultz is an advisor for Auxilium and has received grant support from Endo Pharmaceuticals. Dr Eisenberg has received grant support from Endo Pharmaceuticals. The other authors declare no conflict of interest.
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Eisenberg, M., Li, S., Herder, D. et al. Testosterone therapy and mortality risk. Int J Impot Res 27, 46–48 (2015). https://doi.org/10.1038/ijir.2014.29
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DOI: https://doi.org/10.1038/ijir.2014.29
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