Bisher AKIL, MD

Testosterone Therapy and Blood Clots

In General Health on November 20, 2019 at 9:34 pm

Results from a study published in JAMA Internal Medicine on November 11,2019 was designed  assess whether short-term testosterone therapy exposure is associated with increased short-term risk of venous thromboembolism (VTE or blood clots in veins) in men with and without evidence of hypogonadism.

This case-crossover study analyzed data on 39 622 men from January 1, 2011, to December 31, 2017, with 12 months of follow-up. Men with VTE cases who were free of cancer at baseline and had 12 months of continuous enrollment before the VTE event were identified by International Classification of Diseases codes. Men in the case period were matched with themselves in the control period. Case periods of 6 months, 3 months, and 1 month before the VTE events were defined, with equivalent control periods (6 months, 3 months, and 1 month) in the 6 months before the case period. A total of 39 622 men (mean [SD] age, 57.4 [14.2] years) were enrolled in the study, and 3110 men (7.8%) had evidence of hypogonadism. In age-adjusted models, testosterone therapy use in all case periods was associated with a higher risk of VTE in men with (odds ratio [OR], 2.32; 95% CI, 1.97-2.74) and without (OR, 2.02; 95% CI, 1.47-2.77) hypogonadism. Among men without hypogonadism, the point estimate for testosterone therapy and VTE risk in the 3-month case period was higher for men younger than 65 years (OR, 2.99; 95% CI, 1.91-4.68) than for older men (OR, 1.68; 95% CI, 0.90-3.14), although this interaction was not statistically significant (P = .14).Conclusions   Testosterone therapy was associated with an increase in short-term risk for VTE among men with and without hypogonadism, with some evidence that the association was more pronounced among younger men. These findings suggest that caution should be used when prescribing testosterone therapy.

 

Source:

JAMA Intern Med. Published online November 11, 2019. doi:https://doi.org/10.1001/jamainternmed.2019.5135
Comment: this a retrospective study done by reviewing ,medical record; the cohort is a mix bag in causes, ages and no mentioning of treatment doses; these caveats should be considered when looking at this possibly important finding- need better studies- BA

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