American Association of Clinical Endocrinologists and American College of Endocrinology Position Statement on the Association of Testosterone and Cardiovascular Risk

Goodman, Neil F.; Guay, André T.; Dandona, Paresh; Dhindsa, Sandeep; Faiman, Charles; Cunningham, Glenn R.

doi:10.4158/ep14434.ps

Cited by 65 publications

(48 citation statements)

References 53 publications

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“…In this regard, the American Association of Clinical Endocrinologists and the American College of Endocrinology jointly published their own assessment of the literature, concluding that "there is no compelling evidence that testosterone therapy increases cardiovascular risk." 88 We concur.…”

Section: Discussionmentioning

confidence: 78%

Fundamental Concepts Regarding Testosterone Deficiency and Treatment

Morgentaler

Zitzmann²,

Traish

et al. 2016

Mayo Clinic Proceedings

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To address widespread concerns regarding the medical condition of testosterone (T) deficiency (TD) (male hypogonadism) and its treatment with T therapy, an international expert consensus conference was convened in Prague, Czech Republic, on October 1, 2015. Experts included a broad range of medical specialties including urology, endocrinology, diabetology, internal medicine, and basic science research. A representative from the European Medicines Agency participated in a nonvoting capacity. Nine resolutions were debated, with unanimous approval: (1) TD is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health, and quality of life; (2) symptoms and signs of TD occur as a result of low levels of T and may benefit from treatment regardless of whether there is an identified underlying etiology; (3) TD is a global public health concern; (4) T therapy for men with TD is effective, rational, and evidence based; (5) there is no T concentration threshold that reliably distinguishes those who will respond to treatment from those who will not; (6) there is no scientific basis for any age-specific recommendations against the use of T therapy in men; (7) the evidence does not support increased risks of cardiovascular events with T therapy; (8) the evidence does not support increased risk of prostate cancer with T therapy; and (9) the evidence supports a major research initiative to explore possible benefits of T therapy for cardiometabolic disease, including diabetes. These resolutions may be considered points of agreement by a broad range of experts based on the best available scientific evidence.

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Section: Discussionmentioning

confidence: 78%

Fundamental Concepts Regarding Testosterone Deficiency and Treatment

Morgentaler

Zitzmann²,

Traish

et al. 2016

Mayo Clinic Proceedings

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“…Lastly, the statement indicated that exogenous testosterone should not be used for hypogonadism without a 'defined cause' considered to be a 'disorder of the testicles, pituitary gland, or brain resulting in hypogonadism'. Since the FDA statement, the American Association of Clinical Endocrinologists (AACE) released a position statement acknowledging the 'weak signal' for cardiovascular risk with TRT and stated that 'there is no compelling evidence that testosterone therapy either increases or decreases cardiovascular risk' [Goodman et al 2015]. Furthermore, the AACE statement indicates that 'men with unequivocally low total and/or free testosterone after thorough diagnostic workup should be considered for TRT and extra caution should be exercised in the frail elderly'.…”

Section: Controversies and Riskmentioning

confidence: 99%

Testosterone deficiency in the aging male

McBride

Carson

Coward

2015

Therapeutic Advances in Urology

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Treatment for hypogonadism is on the rise, particularly in the aging population. Yet treatment in this population represents a unique challenge to clinicians. The physiology of normal aging is complex and often shares the same, often vague, symptoms of hypogonadism. In older men, a highly prevalent burden of comorbid medical conditions and polypharmacy complicates the differentiation of signs and symptoms of hypogonadism from those of normal aging, yet this differentiation is essential to the diagnosis of hypogonadism. Even in older patients with unequivocally symptomatic hypogonadism, the clinician must navigate the potential benefits and risks of treatment that are not clearly defined in older men. More recently, a greater awareness of the potential risks associated with treatment in older men, particularly in regard to cardiovascular risk and mortality, have been appreciated with recent changes in the US Food and Drug Administration recommendations for use of testosterone in aging men. The aim of this review is to provide a framework for the clinician evaluating testosterone deficiency in older men in order to identify correctly and treat clinically significant hypogonadism in this unique population while minimizing treatment-associated harm.

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“…По всей видимости, этот феномен был во многом обусловлен именно средствами массовой информации, поскольку он не поддержан никакими научными данными. В этой связи Американская ассоциация клинических эндо-кринологов и Американская коллегия эндокринологов совместно опубликовали свою интерпретацию литера-турных данных, сделав вывод об «отсутствии убеди-тельных данных об увеличении сердечно-сосудистого риска при проведении терапии тестостероном» [88]. Мы согласны с этим заявлением.…”

Section: ответы экспертовunclassified

The consensus recommendations of a group of international experts on the fundamental concepts related to the issues of testosterone deficiency and its treatment.

Morgentaler

Абрахам²,

Zitzmann³

et al. 2016

Obes. metabol.

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Conference on the development of the international expert consensus to address frequently asked questions related to a medical condition of testosterone deficiency (TD, male hypogonadism) and testosterone therapy was held in Prague (Czech Republic) on October 1, 2015. The included experts were representatives from a variety of medical specialties, including urology, endocrinology, diabetology, internal medicine, as well as representatives of basic medical sciences. An international team of experts came to the following conclusions: TD - an important medical condition that affects the health and well-being of men; TD symptoms is a consequence of low testosterone levels, regardless of whether background etiology installed; TD consequences are global; care must be taken in an attempt to use any uniform threshold levels of testosterone for a decision on the appointment of testosterone therapy; a person does not have any reason to refrain from appointing testosterone therapy only on the basis of age; the existing evidence does not suggest increasing the prostate cancer or cardiovascular disease risk during testosterone therapy; there is evidence conserning the feasibility of a major research initiative to explore possible cardioprotective beneficial effects of testosterone therapy in men with metabolic disorders, including diabetes.

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American Association of Clinical Endocrinologists and American College of Endocrinology Position Statement on the Association of Testosterone and Cardiovascular Risk

Cited by 65 publications

References 53 publications

Fundamental Concepts Regarding Testosterone Deficiency and Treatment

Fundamental Concepts Regarding Testosterone Deficiency and Treatment

Testosterone deficiency in the aging male

The consensus recommendations of a group of international experts on the fundamental concepts related to the issues of testosterone deficiency and its treatment.

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