Transdermal androgen relieves dry eye symptoms, elevates QOL in ageing patients
Transdermal androgen appears beneficial to ageing patients with sex hormone deficiency-associated dry eye, with a recent study showing that short-term treatment relieves both symptoms and signs of the condition, as well as improves quality of life (QOL). These benefits are achieved without increasing the incidence of serious side effects.
The study included 26 dry eye patients who were randomized to receive transdermal androgen (androgel; n=25; mean age 61.12 years; 76.0 percent female) or placebo (n=21; mean age 64.24 years; 71.4 percent female) for 4 weeks. Main outcome measures were signs and symptoms of dry eye. Serum levels of sex hormone and QOL were also evaluated at baseline and after treatment.
Following 4 weeks of treatment, androgel yielded significant reduction in ocular surface disease index compared with placebo (–14.36 vs 0.14; p<0.001). The active treatment also produced greater improvements in tear break up time (7.40 vs –1.14 sec; p<0.001), corneal fluorescein staining (–0.62 vs 0.19; p<0.001) and Schirmer test (6.84± vs –0.48 mm; p<0.001).
Serum testosterone levels markedly increased in the androgel vs placebo group (p<0.001) but only in women, whereas neither treatment group showed significant changes in the sex-hormone blinding globulin levels.
In terms of safety, 20 percent of patients presented with oily skin and 4 percent had acne in the androgel group. No serious adverse effects occurred.
Androgel was also associated with increased QOL, with the menopause rating score improving substantially when compared with placebo (p<0.001). However, the ageing male symptoms did not significantly differ between the two treatment groups (p=0.589).
The present data highlight the therapeutic potential of transdermal androgen in patients with dry eye disease. Researchers noted that some patients who received this treatment could stop using artificial tears during treatment, and this suggests the possibility that transdermal androgen could be used instead of artificial tears.
Additional larger, placebo-controlled studies are warranted to explore the titration dose and long-term side effects of transdermal androgen therapy in the population.