Anabolic steroids for the treatment of weight loss in HIV-infected individuals

Johns, Karen Kj; Beddall, MJ; Corrin, RC

doi:10.1002/14651858.cd005483

“…Almost a decade after the IOM’s report [12] the efficacy of testosterone therapy for health outcomes where treatments are not already available remains uncertain. Testosterone compared to placebo could be beneficial for glucose metabolism [65], depression [87,88], sexual dysfunction [26,89], bone density [90] and HIV wasting syndrome [91,92], although whether testosterone is better than established treatments for these conditions has not been clearly established. Cardiovascular disease is common in typical users of testosterone therapy, that is, older men.…”

Section: Discussionmentioning

confidence: 99%

Testosterone therapy and cardiovascular events among men: a systematic review and meta-analysis of placebo-controlled randomized trials

Lin

¹

,

Freeman

²

,

Cowling

³

et al. 2013

BMC Med

View full text Add to dashboard Cite

BackgroundTestosterone therapy is increasingly promoted. No randomized placebo-controlled trial has been implemented to assess the effect of testosterone therapy on cardiovascular events, although very high levels of androgens are thought to promote cardiovascular disease.MethodsA systematic review and meta-analysis was conducted of placebo-controlled randomized trials of testosterone therapy among men lasting 12+ weeks reporting cardiovascular-related events. We searched PubMed through the end of 2012 using “(“testosterone” or “androgen”) and trial and (“random*”)” with the selection limited to studies of men in English, supplemented by a bibliographic search of the World Health Organization trial registry. Two reviewers independently searched, selected and assessed study quality with differences resolved by consensus. Two statisticians independently abstracted and analyzed data, using random or fixed effects models, as appropriate, with inverse variance weighting.ResultsOf 1,882 studies identified 27 trials were eligible including 2,994, mainly older, men who experienced 180 cardiovascular-related events. Testosterone therapy increased the risk of a cardiovascular-related event (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.09 to 2.18). The effect of testosterone therapy varied with source of funding (P-value for interaction 0.03), but not with baseline testosterone level (P-value for interaction 0.70). In trials not funded by the pharmaceutical industry the risk of a cardiovascular-related event on testosterone therapy was greater (OR 2.06, 95% CI 1.34 to 3.17) than in pharmaceutical industry funded trials (OR 0.89, 95% CI 0.50 to 1.60).ConclusionsThe effects of testosterone on cardiovascular-related events varied with source of funding. Nevertheless, overall and particularly in trials not funded by the pharmaceutical industry, exogenous testosterone increased the risk of cardiovascular-related events, with corresponding implications for the use of testosterone therapy.

show abstract

“…Around the 1930s and 1940s, AAS were used clinically in the treatment of disorders including depression, melancholy, and psychosis (Altschule & Tillotson, 1948;Bahrke et al 1990;Danziger et al, 1944). Today, AAS are used clinically in the treatment of disorders including male hypogonadism, anemia, osteoporosis, breast cancer, chronic obstructive pulmonary disease, and muscle wasting in HIV patients (Bhasin & Javanbakht, 1999;Bhasin et al, 2006;Ferreira et al, 1998;Johns, Beddall, & Corrin, 2005). However, the effectiveness of AAS in the treatment of some of these disorders has been debated (Kanayama et al, 2007a;Rabkin et al, 2004).…”

Section: History Of Aasmentioning

confidence: 99%

The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis

Sagoe

¹

,

Molde

²

,

Andreassen

³

et al. 2014

Annals of Epidemiology

View full text Add to dashboard Cite

show abstract

“…Around the 1930s and 1940s, AAS were used clinically in the treatment of disorders including depression, melancholy, and psychosis (Altschule & Tillotson, 1948;Bahrke et al 1990;Danziger et al, 1944). Today, AAS are used clinically in the treatment of disorders including male hypogonadism, anemia, osteoporosis, breast cancer, chronic obstructive pulmonary disease, and muscle wasting in HIV patients (Bhasin & Javanbakht, 1999;Bhasin et al, 2006;Ferreira et al, 1998;Johns, Beddall, & Corrin, 2005). However, the effectiveness of AAS in the treatment of some of these disorders has been debated (Kanayama et al, 2007a;Rabkin et al, 2004).…”

Section: Medical Usage Of Aasmentioning

confidence: 99%