madman
Super Moderator
* Dr. Patel emphasizes that real-world prescribing often differs from controlled trial conditions, particularly with injectable formulations that may result in higher testosterone peaks and greater hematologic effects.
* Dr. Patel stresses the need for careful cardiovascular screening, patient counseling, and ongoing monitoring when prescribing testosterone therapy.
In this Point/Counterpoint presentation from the 32nd Annual Perspectives in Urology meeting, Darshan P. Patel, MD, Associate Professor of Urology, University of California, San Diego, San Diego, California, presents the argument that testosterone therapy can increase cardiac risk for certain cardiovascular conditions.
While large randomized trials such as TRAVERSE have demonstrated non-inferiority for major adverse cardiac events, Dr. Patel explains why these findings do not establish comprehensive cardiovascular safety. He reviews biologic mechanisms associated with testosterone therapy, including polycythemia, atrial fibrillation, and changes in coronary plaque characteristics.
He also discusses early observational studies that raised safety concerns and prompted regulatory action, as well as subsequent updates that highlighted an increased risk of elevated blood pressure. Dr. Patel emphasizes that real-world prescribing often differs from controlled trial conditions, particularly with injectable formulations that may result in higher testosterone peaks and greater hematologic effects.
Dr. Patel stresses the need for careful cardiovascular screening, patient counseling, and ongoing monitoring when prescribing testosterone therapy.
* Dr. Patel stresses the need for careful cardiovascular screening, patient counseling, and ongoing monitoring when prescribing testosterone therapy.
In this Point/Counterpoint presentation from the 32nd Annual Perspectives in Urology meeting, Darshan P. Patel, MD, Associate Professor of Urology, University of California, San Diego, San Diego, California, presents the argument that testosterone therapy can increase cardiac risk for certain cardiovascular conditions.
While large randomized trials such as TRAVERSE have demonstrated non-inferiority for major adverse cardiac events, Dr. Patel explains why these findings do not establish comprehensive cardiovascular safety. He reviews biologic mechanisms associated with testosterone therapy, including polycythemia, atrial fibrillation, and changes in coronary plaque characteristics.
He also discusses early observational studies that raised safety concerns and prompted regulatory action, as well as subsequent updates that highlighted an increased risk of elevated blood pressure. Dr. Patel emphasizes that real-world prescribing often differs from controlled trial conditions, particularly with injectable formulations that may result in higher testosterone peaks and greater hematologic effects.
Dr. Patel stresses the need for careful cardiovascular screening, patient counseling, and ongoing monitoring when prescribing testosterone therapy.
