Symptomatic response rates to testosterone therapy and the likelihood of completing 12 months of therapy in clinical practice.
BACKGROUND
Despite increasing medical interest in testosterone therapy (TTh) for men with testosterone deficiency (TD) there is limited information regarding subjective response rates and acceptability of medium- to long-term TTh in routine clinical practice.


OBJECTIVE
To evaluate results in a consecutive series of men in clinical practice treated with TTh.


METHODS
A chart review was performed for a consecutive series of men for whom TTh was initiated over 1 year for a clinical diagnosis of TD. A diagnosis of TD was based on the presence of symptoms and on laboratory evaluation indicating total testosterone (<300 ng/dL) or free testosterone (FT) (<1.5 ng/dL). Presenting symptoms were noted at baseline, and improvement was documented in domains of erectile function, libido, energy,and mood.


METHODS
Percentage of men who completed 12 months of TTh, and symptomatic response rates.


RESULTS
There were 127 men included in the evaluation. The most common presenting symptoms were the combination of erectile dysfunction (ED) and reduced libido in 82 (64.6%), ED alone in 29 (22.8%), and reduced libido alone in 13 (10.2%). Initial mode of TTh was injections (testosterone enanthate or cypionate) in 70 (55.1%)and transdermal gel (Androgel, Solvay Pharmaceuticals, Marietta, GA, USA) in the remainder. Improvements in erections, libido, energy, and/or mood were reported by 70% of men by 3 months. Eighty men (63%) completed 12 months of TTh with subjective benefit (responders). Treatment was discontinued in 34 (26.8%) who reported no major benefit (non-responders), and 13 (10.2%) were lost to follow-up. Among men who discontinued TTh, 64.7%failed to report benefits by 3 months. Baseline FT was lower among responders than non-responders. One case(1.25%) of prostate cancer was identified after one year of TTh.


CONCLUSIONS
Approximately two-thirds of men with TD who begin TTh will experience symptomatic benefit and will complete at least 12 months of treatment. Benefit was noted in a majority by 3 months.
Rhoden
Ernani Luis
EL
Men's Health Boston, Division of Urology, Harvard Medical School, Boston, MA, USA.
Morgentaler
Abraham
A
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D003692:Delayed-Action Preparations; D007172:Erectile Dysfunction / Q000188:drug therapy*; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000523:psychology*; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000188:drug therapy*; D007267:Injections; D007989:Libido / Q000187:drug effects*; D016013:Likelihood Functions; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D012189:Retrospective Studies; D013739:Testosterone / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood
D003692:Delayed-Action Preparations; D013739:Testosterone; C004648:testosterone enanthate; C016131:testosterone 17 beta-cypionate