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Testosterone Therapy for Hypogonadism Not Tied to Increased CV Risk

No evidence of increase seen for short- to medium-term cardiovascular risk, but data lacking regarding long-term safety

FRIDAY, June 10, 2022 (HealthDay News) — For men with hypogonadism, testosterone therapy does not appear to increase short- to medium-term cardiovascular risk, according to a review published in the June issue of The Lancet Healthy Longevity.

Jemma Hudson, from the University of Aberdeen in the United Kingdom, and colleagues conducted a systematic review and meta-analysis of randomized controlled trials of testosterone versus placebo for men with hypogonadism, including those providing an individual participant dataset (IPD). A total of 35 primary studies with 5,601 participants were deemed suitable for inclusion. Of these, 17 studies (49 percent) with 3,431 participants provided IPD, while 18 studies did not provide IPD.

The researchers found that the risk of bias was low in most IPD studies (71 percent). There were fewer deaths reported with testosterone treatment than placebo (0.4 versus 0.8 percent), although the difference between the groups was not significant. Similar cardiovascular risk was seen during testosterone treatment and placebo treatment. Arrhythmia, coronary heart disease, heart failure, and myocardial infarction were frequently occurring cardiovascular events. There was no evidence of treatment-covariate interaction for patient age, baseline testosterone, smoking status, diabetes status, or baseline cardiovascular or cerebrovascular events.

“Ongoing studies should help to determine the longer-term safety of testosterone but, in the meantime, our results provide much-needed reassurance about its short-to-medium term safety,” Hudson said in a statement. “Our findings could have important implications for the treatment of men with hypogonadism worldwide.”

Several authors disclosed financial ties to the pharmaceutical industry.

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