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Volumn 15, Issue 7, 2014, Pages

To treat or not to treat with testosterone replacement therapy: A contemporary review of management of late-onset hypogonadism and critical issues related to prostate cancer

Author keywords

Atypical small acinar proliferation; Late onset hypogonadism; Prostate cancer; Prostatic intraepithelial neoplasia; Testosterone replacement therapy

Indexed keywords

PROSTATE SPECIFIC ANTIGEN; TESTOSTERONE;

EID: 84901527716     PISSN: 15272737     EISSN: 15346285     Source Type: Journal    
DOI: 10.1007/s11934-014-0422-5     Document Type: Review
Times cited : (11)

References (83)
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    • Adverse events associated with testosterone administration
    • This is a must-read for physicians administering testosterone therapy. The study was performed on extremely debilitated individuals who were started on TRT to determine whether it impacted mobility. The study was prematurely terminated due to a disproportionate number of cardiovascular events within the testosterone treatment arm. It is important to note that testosterone levels were not reported in patients, and a large percentage of patients received very high doses of testosterone, which are not usually administered to average patients with LOH
    • •• 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(2):109-21. This is a must-read for physicians administering testosterone therapy. The study was performed on extremely debilitated individuals who were started on TRT to determine whether it impacted mobility. The study was prematurely terminated due to a disproportionate number of cardiovascular events within the testosterone treatment arm. It is important to note that testosterone levels were not reported in patients, and a large percentage of patients received very high doses of testosterone, which are not usually administered to average patients with LOH.
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    • Basaria, S.1    Coviello, A.D.2    Travison, T.G.3    Storer, T.W.4    Farwell, W.R.5    Jette, A.M.6
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    • This is another "must-read" for practitioners who prescribe testosterone. This retrospective cohort study evaluated men with low testosterone levels who underwent coronary artery angiography in the VA system between 2005 and 2011 were. The study found that the risk of myocardial infarction, stroke, and death was higher in hypogonadal men who were started on TRT than in those who were not treated. There are many controversies and questions regarding the statistical models employed in this study. The raw numbers seem to indicate that there were more adverse events in the untreated group of hypogonadal veterans, but with very complicated statistical weighting, the results are reversed. Because this article was just published,many letters to the editor are expected, so stay tuned...
    • •• 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(17):1829-36. This is another "must-read" for practitioners who prescribe testosterone. This retrospective cohort study evaluated men with low testosterone levels who underwent coronary artery angiography in the VA system between 2005 and 2011 were. The study found that the risk of myocardial infarction, stroke, and death was higher in hypogonadal men who were started on TRT than in those who were not treated. There are many controversies and questions regarding the statistical models employed in this study. The raw numbers seem to indicate that there were more adverse events in the untreated group of hypogonadal veterans, but with very complicated statistical weighting, the results are reversed. Because this article was just published,many letters to the editor are expected, so stay tuned....
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    • Adverse effects of testosterone therapy in adult men: A systematic review and meta-analysis
    • An important level 1 analysis of the current literature that comprehensively evaluates the risks and benefits of TRT. While prior meta-analyses were equally important at the time (references 45, 46), this represents the most current meta-analysis, and therefore it is highlighted
    • • Fernandez-Balsells MM, Murad MH, Lane M, Lampropulos JF, Albuquerque F, Mullan RJ, et al. Adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2010;95:2560-75. An important level 1 analysis of the current literature that comprehensively evaluates the risks and benefits of TRT. While prior meta-analyses were equally important at the time (references 45, 46), this represents the most current meta-analysis, and therefore it is highlighted.
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    • Update in testosterone therapy for men
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    • Jin B, Conway AJ, Handelsman DJ. Effects of androgen deficiency and replacement on prostate zonal volumes. Clin Endocrinol. 2001;54:437-45. (Pubitemid 34204179)
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    • Is testosterone treatment good for the prostate: Study of the safety during long-term treatment
    • This is an important contribution to a field that has too many short term outcomes reported with TRT. IN this article, the authors provide follow up of 1365 men who were placed on TRT, with some men monitored for up to 20 years. Long term safety of TRT is reported. Additionally, the risks of malignancy in these patients is no more than would be expected for the general population of eugonadal men not treated with TRT
    • •• Feneley MR, Carruthers M. Is testosterone treatment good for the prostate: study of the safety during long-term treatment. J Sex Med. 2012;9:2138-49. This is an important contribution to a field that has too many short term outcomes reported with TRT. IN this article, the authors provide follow up of 1365 men who were placed on TRT, with some men monitored for up to 20 years. Long term safety of TRT is reported. Additionally, the risks of malignancy in these patients is no more than would be expected for the general population of eugonadal men not treated with TRT.
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    • Changes in prostate specific antigen in hypogonadal men after 12 months of testosterone replacement therapy: Support for the prostate saturation theory
    • Another important study in the field, which provides prospective follow up of hypogonadal men on TRT. Serum PSA levels increased more profoundly in those men with T levels of 250 ng/dl at baseline than in those with levels above this at baseline. Overall, the latter group did not demonstrate a statistically significant increase in the serum PSA following TRT, an important fact to understand when treating men with TRT
    • •• Khera M, Bhattacharya RK, Blick G, Kushner H, Nguyen D, Miner M. Changes in prostate specific antigen in hypogonadal men after 12 months of testosterone replacement therapy: support for the prostate saturation theory. J Urol. 2011;186:1005-11. Another important study in the field, which provides prospective follow up of hypogonadal men on TRT. Serum PSA levels increased more profoundly in those men with T levels of 250 ng/dl at baseline than in those with levels above this at baseline. Overall, the latter group did not demonstrate a statistically significant increase in the serum PSA following TRT, an important fact to understand when treating men with TRT.
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    • Shifting the paradigm of testosterone and prostate cancer: The saturation model and the limits of androgen-dependent growth
    • The authors outline one of the most important concepts that underlie how we currently approach TRT. The saturation model is discussed above, and is a very important contribution to andrology and oncology
    • •• Morgentaler A, Traish AM. Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth. Eur Urol. 2009;55:310-21. The authors outline one of the most important concepts that underlie how we currently approach TRT. The saturation model is discussed above, and is a very important contribution to andrology and oncology.
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    • Coward RM, Simhan J, Carson III CC. Prostate-specific antigen changes and prostate cancer in hypogonadal men treated with testosterone replacement therapy. BJU Int. 2008;103:1179-83.
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* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.