madman
Super Moderator
Effectiveness of testosterone therapy in hypogonadal patients and its controversial adverse impact on the cardiovascular system
ABSTRACT
Testosterone is the major male hormone produced by testicles that are directly associated with man’s appearance and secondary sexual developments. Androgen deficiency starts when the male hormonal level falls from its normal range though, in youngsters, the deficiency occurs due to disruption of the normal functioning of pituitary, hypothalamus glands, and testes. Thus, testosterone replacement therapy was already known for the treatment of androgen deficiency with lesser risks of producing cardiovascular problems. Since from previous years, the treatment threshold in the form of testosterone replacement therapy has effectively increased to that extent that it was prescribed for those conditions which it was considered inappropriate. However, there are some research studies and clinical trials available that proposed a higher risk of inducing cardiovascular disease with the use of testosterone replacement therapy. Thus under the light of these results, the FDA has published the report of the increased risk of cardiovascular disease with the increased use of testosterone replacement therapy. Nevertheless, there is not a single trial available or designed that could evaluate the risk of cardiovascular events with the use of testosterone replacement therapy. As a result, the use of testosterone still questioned the cardiovascular safety of this replacement therapy. Thus, this literature outlines the distribution pattern of disease by investigating the data and link between serum testosterone level and the cardiovascular disease, also the prescription data of testosterone replacement therapy patients and their tendency of inducing cardiovascular disease, meta-analysis and the trials regarding testosterone replacement therapy and its connection with the risks of causing cardiovascular disease and lastly, the possible effects of testosterone replacement therapy on the cardiovascular system. This study aims to evaluate the available evidence regarding the use of testosterone replacement therapy when choosing it as a treatment plan for their patients
Effect of endogenous testosterone on the cardiovascular events – The TRNASVERSE trial
TRAVERSE trial (US National Library of Medicine) is known as the first randomized controlled trial that is used to analyze the cardiovascular events that occurred due to testosterone replacement therapy. Thus, to start these trials in 2018 researchers plan a scheme with 6000 men ranging between 45 and 80 years of age who were at risk of cardiovascular disease were treated with testosterone <300 ng/dl in gel form or treated with placebo. The treatment period selected for this plan was 5 years and the foremost endpoint selected for this study was MACE (nonfatal MI, nonfatal stroke, or death from cardiovascular causes). The other secondary results are achieved from the occurrence of the cardiovascular endpoint. The findings associated with these trials provide the documented results of cardiovascular safety by the use of testosterone replacement therapy.
Conclusions
T plays an important role in regulating body functions which include the cardiovascular system and metabolic system of the body. However, the population study contradicts the collected data and the clinical trials conducted yet. There are many studies still present that corroborate the facts about mortality due to testosterone replacement therapy. While several other studies in randomized trials documented the increased severity of cardiovascular risks due to testosterone therapy. Some contradictions were also seen in meta-analyses and were constrained in the range of low to medium trials. In addition, till now there is no authentic publication or research available that has the capability to evaluate its effect on cardiovascular risks associated with T. Thus for this purpose, a TRAVERSE trial (US National Library of Medicine) uses long-term treatment and the conclusions for the evaluation of cardiovascular events produced due to testosterone therapy. Thus, it is necessary to make patients aware of the cardiovascular events induced by testosterone replacement therapy.
ABSTRACT
Testosterone is the major male hormone produced by testicles that are directly associated with man’s appearance and secondary sexual developments. Androgen deficiency starts when the male hormonal level falls from its normal range though, in youngsters, the deficiency occurs due to disruption of the normal functioning of pituitary, hypothalamus glands, and testes. Thus, testosterone replacement therapy was already known for the treatment of androgen deficiency with lesser risks of producing cardiovascular problems. Since from previous years, the treatment threshold in the form of testosterone replacement therapy has effectively increased to that extent that it was prescribed for those conditions which it was considered inappropriate. However, there are some research studies and clinical trials available that proposed a higher risk of inducing cardiovascular disease with the use of testosterone replacement therapy. Thus under the light of these results, the FDA has published the report of the increased risk of cardiovascular disease with the increased use of testosterone replacement therapy. Nevertheless, there is not a single trial available or designed that could evaluate the risk of cardiovascular events with the use of testosterone replacement therapy. As a result, the use of testosterone still questioned the cardiovascular safety of this replacement therapy. Thus, this literature outlines the distribution pattern of disease by investigating the data and link between serum testosterone level and the cardiovascular disease, also the prescription data of testosterone replacement therapy patients and their tendency of inducing cardiovascular disease, meta-analysis and the trials regarding testosterone replacement therapy and its connection with the risks of causing cardiovascular disease and lastly, the possible effects of testosterone replacement therapy on the cardiovascular system. This study aims to evaluate the available evidence regarding the use of testosterone replacement therapy when choosing it as a treatment plan for their patients
Effect of endogenous testosterone on the cardiovascular events – The TRNASVERSE trial
TRAVERSE trial (US National Library of Medicine) is known as the first randomized controlled trial that is used to analyze the cardiovascular events that occurred due to testosterone replacement therapy. Thus, to start these trials in 2018 researchers plan a scheme with 6000 men ranging between 45 and 80 years of age who were at risk of cardiovascular disease were treated with testosterone <300 ng/dl in gel form or treated with placebo. The treatment period selected for this plan was 5 years and the foremost endpoint selected for this study was MACE (nonfatal MI, nonfatal stroke, or death from cardiovascular causes). The other secondary results are achieved from the occurrence of the cardiovascular endpoint. The findings associated with these trials provide the documented results of cardiovascular safety by the use of testosterone replacement therapy.
Conclusions
T plays an important role in regulating body functions which include the cardiovascular system and metabolic system of the body. However, the population study contradicts the collected data and the clinical trials conducted yet. There are many studies still present that corroborate the facts about mortality due to testosterone replacement therapy. While several other studies in randomized trials documented the increased severity of cardiovascular risks due to testosterone therapy. Some contradictions were also seen in meta-analyses and were constrained in the range of low to medium trials. In addition, till now there is no authentic publication or research available that has the capability to evaluate its effect on cardiovascular risks associated with T. Thus for this purpose, a TRAVERSE trial (US National Library of Medicine) uses long-term treatment and the conclusions for the evaluation of cardiovascular events produced due to testosterone therapy. Thus, it is necessary to make patients aware of the cardiovascular events induced by testosterone replacement therapy.
