Testosterone substitution with a new transdermal, hydroalcoholic gel applied to scrotal or non-scrotal skin: a multicentre trial.
OBJECTIVE
Testosterone-containing gels have improved testosterone substitution therapy, but they are associated with the risk of interpersonal transfer. Therefore, we tested a new hydroalcoholic 2.5% testosterone gel (TGW), which was removed by washing 10 min after administration.


METHODS
The gel was applied to scrotal or non-scrotal skin in comparison to two 2.5 mg Androderm patches in a randomised, three-arm, parallel-group, controlled multicentre trial over a period of 24 weeks. We included symptomatic hypogonadal men whose morning testosterone levels were <10 nmol/l. Either 1 g TGW was applied to scrotal skin (n = 54) or 5 g to non-scrotal skin (n = 56) once daily; the patch group (n = 52) applied two patches/day. Dose titration was allowed.


RESULTS
Whereas serum testosterone levels and the pre-post changes of the areas under the curve of testosterone and free testosterone between weeks 0 and 24 indicated equivalent treatment success for the patch and scrotal groups, the dermal gel group was significantly superior to the other two groups. Questionnaires on sexual function, mood and quality of life did not differ significantly between study groups, nor were prostate volume, prostate-specific antigen (PSA) levels and prostate symptoms different. However, tolerability was much better in the gel groups than the patch group.


CONCLUSIONS
Efficacy, safety and tolerability suggest TGW as a favourable treatment for hypogonadal patients.
Kühnert
B
B
Institute of Reproductive Medicine, Münster, Germany.
Byrne
M
M
Simoni
M
M
Köpcke
W
W
Gerss
J
J
Lemmnitz
G
G
Nieschlag
E
E
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000728:Androgens / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D013196:Dihydrotestosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood; D005782:Gels; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D011467:Prostate / Q000033:anatomy & histology; D017430:Prostate-Specific Antigen / Q000097:blood; D012611:Scrotum; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood
D000728:Androgens; D005782:Gels; D013196:Dihydrotestosterone; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D017430:Prostate-Specific Antigen