Testosterone replacement therapy in the ageing man

It is time for a large trial of testosterone therapy for older men

“…Lean mass, mainly muscle, increased in 13 of 15 RCTs, including 12 of the 13 exceeding 3 months [2]. The average increase was 1-3 kg with no significant change after 6 months.…”

“…In some of the RCTs increase in muscle mass was associated with significant improvements in muscle strengths mainly in the upper limbs, with a significant increase in handgrip strength in 4 of 8 studies [2]. Strength in lower extremities increased in only one of six studies.…”

“…Results of well-designed, short-term, placebo-controlled, randomized trials (RCTs) of T therapy in ageing men had already shown short-term beneficial effects of this therapy, and supported its safety within the 3 first years of treatment [2], suggesting it was time for a large long-term trial of T therapy in older men.…”

“…We analysed 43 RCTs meeting the criteria age of male patients >50 years, baseline T low to low normal for normal young adults (<50 years old), treatment with T preparations [2]. The benefit of treatment was ascribed to T therapy only if significantly greater than the placebo.…”

“…This has clinical relevance because the amount of visceral fat is highly significantly associated with impaired glucose tolerance, non-insulin dependent diabetes mellitus and an increased risk of cardiovascular disease [3]. Fat mass, mainly abdominal and visceral fat, decreased in 13 of 17 RCTs [2]. Although limited (1.5 to 2.5 kg), the decrease was statistically significant in 12 of 14 trials run for over 3 months.…”