Prostate-Specific Antigen Levels During Testosterone Treatment of Hypogonadal Older Men: Data from a Controlled Trial.

Autor:	Cunningham GR; Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Baylor St. Luke's Medical Center, Houston, Texas., Ellenberg SS; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Bhasin S; Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Matsumoto AM; Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, Washington.; Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington., Parsons JK; Department of Urology, Moores Comprehensive Cancer Center, University of California San Diego, San Diego, California., Preston P; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Cauley JA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania., Gill TM; Division of Geriatric Medicine, Yale School of Medicine, New Haven, Connecticut., Swerdloff RS; Division of Endocrinology, Harbor-University of California at Los Angeles Medical Center, Torrance, California.; Los Angeles Biomedical Research Institute, Torrance, California., Wang C; Division of Endocrinology, Harbor-University of California at Los Angeles Medical Center, Torrance, California.; Los Angeles Biomedical Research Institute, Torrance, California., Ensrud KE; Department of Medicine, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota.; Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota., Lewis CE; Department of Epidemiology, School of Public Health at UAB, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama., Pahor M; Department of Aging & Geriatric Research, University of Florida, Gainesville, Florida., Crandall JP; Divisions of Endocrinology and Geriatrics, Albert Einstein College of Medicine, Bronx, New York., Molitch ME; Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois., Cifelli D; Center for Clinical Epidemiology & Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Basaria S; Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Diem SJ; Department of Medicine, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota.; Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota., Stephens-Shields AJ; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Hou X; Center for Clinical Epidemiology & Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Snyder PJ; Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2019 Dec 01; Vol. 104 (12), pp. 6238-6246.
DOI:	10.1210/jc.2019-00806
Abstrakt:	Context: Prostate-specific antigen (PSA) changes during testosterone treatment of older hypogonadal men have not been rigorously evaluated. Design: Double-blinded, placebo-controlled trial. Setting: Twelve US academic medical centers. Participants: Seven hundred ninety hypogonadal men ≥65 years of age with average testosterone levels ≤275 ng/dL. Men at high risk for prostate cancer were excluded. Interventions: Testosterone or placebo gel for 12 months. Main Outcomes: Percentile changes in PSA during testosterone treatment of 12 months. Results: Testosterone treatment that increased testosterone levels from 232 ± 63 ng/dL to midnormal was associated with a small but substantially greater increase (P < 0.001) in PSA levels than placebo treatment. Serum PSA levels increased from 1.14 ± 0.86 ng/mL (mean ± SD) at baseline by 0.47 ± 1.1 ng/mL at 12 months in the testosterone group and from 1.25 ± 0.86 ng/mL by 0.06 ± 0.72 ng/mL in the placebo group. Five percent of men treated with testosterone had an increase ≥1.7 ng/mL and 2.5% of men had an increase of ≥3.4 ng/mL. A confirmed absolute PSA >4.0 ng/mL at 12 months was observed in 1.9% of men in the testosterone group and 0.3% in the placebo group. Four men were diagnosed with prostate cancer; two were Gleason 8. Conclusions: When hypogonadal older men with normal baseline PSA are treated with testosterone, 5% had an increase in PSA ≥1.7 ng/mL, and 2.5% had an increase ≥3.4 ng/mL. (Copyright © 2019 Endocrine Society.)
Databáze:	MEDLINE
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