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Efficacy and safety of two different testosterone undecanoate formulations in hypogonadal men with metabolic syndrome

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Abstract

Aim: To investigate efficacy and safety of two different preparations of testosterone undecanoate (TU) in 52 hypogonadal men [mean age 57 yr and mean testosterone (T) < 320 ng/dl] with metabolic syndrome (MS). Subjects and methods: Randomized, double-blind, double-dummy study with three parallel treatment arms [oral TU; transdermal placebo gel (P); im TU] administration for 12 months (mo). Each subject was randomized (1:1:3) to receive either oral TU (2 capsules of 40 mg/twice per day at breakfast and dinner, equalling a total dose of 160 mg/day; no.=10) for 6 mo and continued with im TU for further 6 mo, or P (3–4 g/day; no.=10) and im TU (1000 mg/12 weeks from week 6; no.=32) for 12 mo. Results: After 6 mo, im TU increased T and free-T levels (p<0.0001), and improved metabolic parameters [reduction in Homeostasis Model Assessment (HOMA) index, p<0.0001; waist circumference and fat mass, p<0.001, respectively], in International Index of Erectile Function-5 and Aging Males’ Symptoms scores (p<0.01, respectively). After 12 months, im TU produced further increases in T and free-T levels (p<0.0001) and metabolic parameters (reduction in HOMA-index, p<0.0001; waist circumference p<0.0001; fat mass, p<0.001). No major adverse event due to T treatment occurred. Conclusions: Clinical efficacy of T replacement therapy in hypogonadal men with MS is reached when its plasmatic levels approach into the medium-high range of normality (>5 ng/ml), although subjective threshold values may be different. Administration of im TU was more effective than oral TU to reach the target for T levels and to improve MS parameters. TU was safe over 12 months and discontinuation rates were similar to placebo.

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Authors and Affiliations

  1. Dipartimento Fisiopatologia Medica, Università Sapienza di Roma, Viale Policlinico 155, 00161, Rome, Italy

    Antonio Aversa MD, PhD, R. Bruzziches, D. Francomano, G. Spera & A. Lenzi

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  1. Antonio Aversa MD, PhD
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  2. R. Bruzziches
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Correspondence to Antonio Aversa MD, PhD.

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Aversa, A., Bruzziches, R., Francomano, D. et al. Efficacy and safety of two different testosterone undecanoate formulations in hypogonadal men with metabolic syndrome. J Endocrinol Invest 33, 776–783 (2010). https://doi.org/10.1007/BF03350341

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