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| |  DG DISPATCH - ACR: Testosterone Therapy Effective For Men With Osteoporosis By Maria Bishop Special to DG News BOSTON, MA -- November 17, 1999 -- A significant number of men referred to specialized bone clinics suffer from osteoporosis. But while many advances in hormone therapy have been made in treating osteoporosis in women, research on hormone therapy in men has been less conclusive. Now, according to new research, testosterone therapy may form a potent tool in the therapeutic armamentarium against osteoporosis in men.
At the Clinical Osteoporosis: Bone Metabolism I poster session of the 63rd Annual Scientific Meeting of the American College of Rheumatology (ACR), in Boston, MA, Dr. Inigo Aretxabal, and colleagues offered their research as an efficacy assessment for testosterone compared with cyclical etidronate (standard therapy) in men with osteoporosis. The study was conducted on men referred between 1990 and 1998 to the group’s bone clinic in Truro, Cornwall, in England, for bone mineral density (BMD) measurement. Of 383 men referred, 202 were diagnosed as having osteoporosis based on the World Health Organization (WHO) definition. All referred patients, at first visit, were administered a standardized, interviewer-assisted, risk-factor assessment questionnaire. Androgen status was assessed by measuring serum testosterone in those subjects for whom no clinical risk factors for osteoporosis had been identified. Based on patients’ gonadal status, they were then treated with either testosterone injections (250 mg IMI every three weeks) or cyclical etidronate. Patients on either therapy had repeat BMD measurements performed at a 12-to-18 month interval, as a matter of course. For purposes of the study, subjects were identified who were on either of the two therapies and had had at least two BMD measurements performed. Outcome (defined as “the mean percent change in BMD per year between the first and the last BMD measurements [gm/cm2] at both the lumbar spine and proximal femur”) was then compared for the two treatment methods. In the end, there were 44 patients examined in each treatment group. Mean values for annual percentage of change in BMD measurements were noted. In the lumbar spine, only improvements were seen: +1.72 percent for testosterone and +2.50 percent for cyclical etidronate. In the femoral neck, percentage changes showed a +0.09 percent improvement for testosterone, but a -1.1 percent decrease for patients on cyclical etidronate. The most common comorbid condition for subjects was respiratory diseases (19). As risk factors, excess alcohol intake (12) and corticosteroid therapy (nine in the testosterone group and 15 in the etidronate group) were common in both groups. Testosterone-treated patients were generally younger and had higher baseline BMD measurements. Only two of the 44 patients on testosterone treatment experienced minor side effects. The research team also noted that, in addition to being at risk for osteoporosis through the same lifestyle factors as women, men with osteoporosis are also commonly afflicted with subclinical hypogonadism. Testosterone therapy in hypogonadal osteoporotic men shows a similar therapeutic profile as etidronate does in eugonadal men. Therefore, assessment of androgen status should be part of the routine workup in a man presenting with osteoporosis. Keeping this in mind, concluded Dr. Aretxabala, testosterone therapy appears to be acceptable and effective in treating men with osteoporosis. Dr. Aretxabala’s work is supported by a grant from the Department of Health of the Basque Government (Basque Country, Spain).
Related Links: HRT (hormone replacement therapy).
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