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Higher adherence to topical testosterone improves clinical outcomes in men with hypogonadism

11 Feb 2018

In males with primary or secondary hypogonadism (HG), adherence to topical testosterone therapy (TTh) appears to improve total testosterone and decrease the risk of conditions associated with HG, a recent study has shown.

Researchers performed a retrospective cohort study of 3,184 adult males (mean age 49 years) with primary or secondary HG initiating topical TTh. The rate of complete adherence for 12 months was only 16.9 percent (n=538). Majority of the participants (91 percent) were prescribed topical gels.

High adherence was associated with better clinical outcomes. For instance, the composite endpoint of fatigue, osteoarthritis, insomnia, depression and erectile dysfunction was significantly lower in those adherent to the topical TTh (adjusted odds ratio [OR], 0.764; 95 percent CI, 0.617–0.947; p=0.014).

The secondary composite outcome of obesity, diabetes or metabolic syndrome was not significantly affected by adherence (adjusted OR, 0.952; 0.723–1.252; p=0.723). None of the individual composite components were also significantly correlated with adherence.

While both adherent and nonadherent males experienced increases in total testosterone levels relative to baseline, those who were adherent to the topical TTh had a 45-percent greater improvement, which reached statistical significance (239 vs 165 ng/dL; p<0.01).

After adjustments for covariates, adherence to TTh significantly predicted a mean increase of 63 mg/dL in testosterone concentrations relative to nonadherent participants (p<0.01).

In a separate multivariable analysis, geographical region, year of treatment initiation, prescribing physician, and baseline depression, hypertension, obesity and osteoporosis were all significant predictors of adherence.

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