Late‐onset hypogonadism a challenging task for the andrology field

Corona, Giovanni; Krausz, Csilla

doi:10.1111/andr.12917

Cited by 9 publications

(4 citation statements)

References 13 publications

(56 reference statements)

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“…This issue was based on lectures presented at the 25th North American Testis Workshop and was edited by Vassilios Papadopoulos 10 ‘Late‐onset hypogonadism’, edited by Giovanni Corona and Csilla Krausz 11 . This issue contains 13 review articles and several thematically related original studies. …”

Section: News From Andrologymentioning

confidence: 99%

European Academy of Andrology: Annual Report 2020

Meyts

Krausz

2021

Andrology

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Section: News From Andrologymentioning

confidence: 99%

European Academy of Andrology: Annual Report 2020

Meyts

Krausz

2021

Andrology

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“…Societies outside the United States largely are in agreement with the clinical practice guideline set by the Endocrine Society, with most societies recommending a cutoff of either 10.4 nmol/L (300 ng/dl) or 12–12.1 nmol/L (346–350 ng/dl) as the mean total T cutoff for TD diagnosis and during follow‐up. There are slight differences in diagnostic workup and follow‐up 4 ; for example, the Endocrine of Society of Australia has recommended separate mean total T (TT) cutoffs to diagnose TD for young men and men older than 70 years, possibly to reflect the lower mean total T levels seen in older men 5–8 . In addition, “adult‐onset hypogonadism” or “late‐onset hypogonadism” (LOH), as defined by the Sexual Medicine Society of North America (SMSNA), is a syndrome characterized by clinical and biochemical evidence of low T with advancing age 7 .…”

Section: Introductionmentioning

confidence: 99%

“…There are slight differences in diagnostic workup and follow‐up 4 ; for example, the Endocrine of Society of Australia has recommended separate mean total T (TT) cutoffs to diagnose TD for young men and men older than 70 years, possibly to reflect the lower mean total T levels seen in older men. 5 , 6 , 7 , 8 In addition, “adult‐onset hypogonadism” or “late‐onset hypogonadism” (LOH), as defined by the Sexual Medicine Society of North America (SMSNA), is a syndrome characterized by clinical and biochemical evidence of low T with advancing age. 7 Currently, only the European Academy of Andrology (EAA) and the SMSNA have provided recommendations for the short‐term treatment of LOH with TTh.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics of testosterone therapies in relation to diurnal variation of serum testosterone levels as men age

et al. 2021

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Background: To improve symptoms associated with testosterone deficiency, many testosterone therapies are available that aim to restore serum testosterone (T) levels to the normal physiologic range. The magnitude, frequency, and duration between peak and trough T concentrations vary with route of administration, and none reflect normal endogenous daily diurnal T variations.Objective: To compare pharmacokinetic profiles of serum T from approved T formulations with endogenous diurnal T variations in young and older men, and to consider whether there may be value in mimicking the diurnal T rhythmicity with exogenous testosterone therapies as men age. Materials and methods:A literature search of studies examining the diurnal variation of endogenous T in healthy men and men with testosterone deficiency was performed using PubMed in January 2020. Additional searches for serum T pharmacokinetic profiles of various testosterone therapy formulations were also conducted. Prescribing information for various T formulations was also reviewed. Discussion and conclusion:Endogenous diurnal T variation is well described and appears to be blunted naturally as men age. Men with testosterone deficiency lack diurnal T variation and exhibit a flatter T profile compared with eugonadal men. Some T replacement options provide intraday T level variations similar to normal circadian secretion, and others provide a flatter exposure profile reflective of depot release. Others provide profiles that exceed the frequency and physiologic range of the natural diurnal variation of T. All exogenous T replacement dosing targets an increase in average T levels to within the normal physiologic range and improves symptoms associated with low T, but no single testosterone therapy can exactly mimic the normal diurnal T patterns seen in younger men and the blunted circadian T secretion of older men.

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“…Unfortunately, the generalization of the study results was hampered by 2 major limitations: (1) the study was early interrupted when 1/3 of planned patients were enrolled, (2) only 7% of patients randomized to ADT withdrawal achieved a serum testosterone level >0.5 ng/ml in the offtherapy phase, in contrast with the reported time to testosterone normalization of about 3 months in HSPC patients in the off phase of intermittent ADT schedules [12]. Testicular atrophy, due to the long-term ADT exposure in the majority of the PON-PC patients, could be a plausible explanation for this phenomenon [13][14][15].…”

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Maintenance of androgen deprivation therapy or testosterone supplementation in the management of castration-resistant prostate cancer: that is the question

et al. 2022

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Purpose Whether or not androgen receptor (AR) axis could still be targetable in castration resistant prostate cancer (CRPC) patients with disease progression to next generation hormonal agents (NGHAs) is a controversial issue. Results Serum testosterone in CRPC patients has a positive prognostic role and increasing testosterone levels after androgen deprivation therapy (ADT) withdrawal or testosterone supplementation, as part of a bipolar androgen therapy (BAT) strategy, has been shown to potentially restore sensitivity to previous lines of NGHAs. Conclusion These data suggest that maintenance of ADT in CRPC patients receiving further lines of treatment, as recommended by current international guidelines, could be questionable. Conversely, testosterone supplementation aimed to re-sensitize CRPC to further hormonal manipulation is a strategy worth to be explored in future clinical trials.

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Late‐onset hypogonadism a challenging task for the andrology field

Cited by 9 publications

References 13 publications

European Academy of Andrology: Annual Report 2020

European Academy of Andrology: Annual Report 2020

Pharmacokinetics of testosterone therapies in relation to diurnal variation of serum testosterone levels as men age

Maintenance of androgen deprivation therapy or testosterone supplementation in the management of castration-resistant prostate cancer: that is the question

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