Testosterone treatment in male patients with Klinefelter syndrome: a systematic review and meta-analysis

Pizzocaro, Alessandro; Vena, Walter; Condorelli, Rosita A.; Radicioni, A.; Rastrelli, Giulia; Pasquali, Daniela; Selice, Riccardo; Ferlin, Alberto; Foresta, Carlo; Jannini, Emmanuele A.; Maggi, Mario; Lenzi, Andrea; Pivonello, Rosario; Isidori, Andrea M.; Garolla, Andrea; Francavilla, Sandro; Corona, Giovanni

doi:10.1007/s40618-020-01299-1

Cited by 51 publications

(48 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Testosterone replacement therapy outcomes observed in KS patients are similar to those reported in males with hypogonadism unrelated to KS [15]. In particular, body composition and bone mineral density appear better in treated than untreated hypogonadal KS patients [18].…”

Section: Discussionsupporting

confidence: 68%

“…Treatment of KS aims to decrease symptoms, enhance functionality, and improve the wellbeing of patients and their family environment, as likewise occurs in most chronic disorders. Testosterone replacement therapy, which is the accepted standard of care in KS patients, indeed, produces no effect on infertility caused by the disease, but corrects the androgen deficiency, and provides patients with appropriate virilization (improved libido, sexual activity, nocturnal erections, sexual thoughts, and sexual satisfaction), considerable increased skeletal muscle strength and hematocrit, plus reduced bone resorption [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Quality of life in Klinefelter patients on testosterone replacement therapy compared to healthy controls: an observational study on the impact of psychological distress, personality traits, and coping strategies

Fabrazzo

Accardo

Abbondandolo

et al. 2020

J Endocrinol Invest

Self Cite

View full text Add to dashboard Cite

Purpose We aimed to verify if 1 year-testosterone-replacement therapy could produce a psychopathological recovery and a satisfactory quality of life in Klinefelter syndrome (KS) patients compared to matched healthy controls. Further, we analyzed personality traits and coping strategies, an issue not yet examined in androgen-treated KS patients. We also enquired whether any of the sociodemographic and psychological variables might predict a patient's general and sexual life satisfaction. Methods The Quality of Life Enjoyment and Satisfaction Questionnaire and the Temperament and Character Inventory-Revised were administered to both 23 KS patients and matched healthy subjects. Psychopathology was investigated by the Symptom Checklist-90-Revised (SCL-90-R) and the Mini-mental State Examination. The COPE Inventory was used to identify cognitive and behavioral strategies to manage disease-related distress. Results In testosterone-treated KS patients, when compared with controls, SCL-90-R subscales analysis evidenced high psychological distress, mainly presented as obsessive thoughts, hanger-hostility, phobias, and psychoticism. Self-directedness and self-transcendence, along with the prevalent use of emotion-focused coping strategies, outlined the personality of our KS patients. Depression and somatization proved to be predictors of general life dissatisfaction. Depression, anger-hostility, and paranoid ideation, instead, emerged as predictors of sexual life dissatisfaction. Conclusion Endocrinologists should cooperate with mental health providers to foster a better outcome of the disease in KS patients.

show abstract

Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Quality of life in Klinefelter patients on testosterone replacement therapy compared to healthy controls: an observational study on the impact of psychological distress, personality traits, and coping strategies

Fabrazzo

Accardo

Abbondandolo

et al. 2020

J Endocrinol Invest

Self Cite

View full text Add to dashboard Cite

show abstract

“…On the other hand, testosterone treatment in hypogonadal men with KS improved body composition and BMD at the spinal level. The effects on lipid and glucose profile were less significant evident 129 . Larger and longer placebo‐controlled RCT is necessary however to fully understand the benefits of testosterone treatment in KS.…”

Section: Clinical Pictures Diagnostic Steps and Therapymentioning

confidence: 95%

“…However, the latter cannot entirely explain the increased CV risk and other factors (such as epigenetic mechanisms and AR functionality) are most likely involved 4,6,9,142 . Accordingly, testosterone replacement therapy does not completely attenuate the increased cardiometabolic risk 129 …”

Section: Clinical Pictures Diagnostic Steps and Therapymentioning

confidence: 98%

“…Randomized controlled trials are needed to elucidate the role of testosterone substitution in patients with KS in the prevention of an unfavourable body composition, metabolic syndrome and type 2 diabetes mellitus. A recent meta‐analysis demonstrates that testosterone substitution ameliorates body composition, but not other cardiovascular risk factor 129 . However, this conclusion is drawn mainly from observational studies (also see 4.4.1).…”

Section: Clinical Pictures Diagnostic Steps and Therapymentioning

confidence: 99%

See 1 more Smart Citation

European academy of andrology guidelines on Klinefelter Syndrome Endorsing Organization: European Society of Endocrinology

et al. 2020

View full text Add to dashboard Cite

Background Knowledge about Klinefelter syndrome (KS) has increased substantially since its first description almost 80 years ago. A variety of treatment options concerning the spectrum of symptoms associated with KS exists, also regarding aspects beyond testicular dysfunction. Nevertheless, the diagnostic rate is still low in relation to prevalence and no international guidelines are available for KS. Objective To create the first European Academy of Andrology (EAA) guidelines on KS. Methods An expert group of academicians appointed by the EAA generated a consensus guideline according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system. Results Clinical features are highly variable among patients with KS, although common characteristics are severely attenuated spermatogenesis and Leydig cell impairment, resulting in azoospermia and hypergonadotropic hypogonadism. In addition, various manifestations of neurocognitive and psychosocial phenotypes have been described as well as an increased prevalence of adverse cardiovascular, metabolic and bone‐related conditions which might explain the increased morbidity/mortality in KS. Moreover, compared to the general male population, a higher prevalence of dental, coagulation and autoimmune disorders is likely to exist in patients with KS. Both genetic and epigenetic effects due to the supernumerary X chromosome as well as testosterone deficiency contribute to this pathological pattern. The majority of patients with KS is diagnosed during adulthood, but symptoms can already become obvious during infancy, childhood or adolescence. The paediatric and juvenile patients with KS require specific attention regarding their development and fertility. Conclusion These guidelines provide recommendations and suggestions to care for patients with KS in various developmental stages ranging from childhood and adolescence to adulthood. This advice is based on recent research data and respective evaluations as well as validations performed by a group of experts.

show abstract

Hypothalamic–Pituitary Axis Function

Mazzella¹,

Angelis²,

Menafra³

et al. 2020

Klinefelter’s Syndrome

View full text Add to dashboard Cite

Testosterone treatment in male patients with Klinefelter syndrome: a systematic review and meta-analysis

Cited by 51 publications

References 65 publications

Quality of life in Klinefelter patients on testosterone replacement therapy compared to healthy controls: an observational study on the impact of psychological distress, personality traits, and coping strategies

Quality of life in Klinefelter patients on testosterone replacement therapy compared to healthy controls: an observational study on the impact of psychological distress, personality traits, and coping strategies

European academy of andrology guidelines on Klinefelter Syndrome Endorsing Organization: European Society of Endocrinology

Hypothalamic–Pituitary Axis Function

Contact Info

Product

Resources

About