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The efficacy and adverse events of testosterone replacement therapy in hypogonadal men: A systematic review and meta-analysis of randomized, placebo-controlled trials

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dc.contributor.author Ponce, Oscar J.
dc.contributor.author Spencer-Bonilla, Gabriela
dc.contributor.author Alvarez-Villalobos, Neri
dc.contributor.author Serrano, Valentina
dc.contributor.author Singh-Ospina, Naykky
dc.contributor.author Rodriguez-Gutierrez, Rene
dc.contributor.author Salcido-Montenegro, Alejandro
dc.contributor.author Benkhadra, Raed
dc.contributor.author Prokop, Larry J.
dc.contributor.author Bhasin, Shalender
dc.contributor.author Brito, Juan P.
dc.date.accessioned 2018-11-30T23:41:29Z
dc.date.available 2018-11-30T23:41:29Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4189
dc.description.abstract Context: The efficacy and safety of testosterone replacement therapy (TRT) in hypogonadal men remain incompletely understood. Objective: To conduct a systematic review and meta-analysis of randomized clinical trials (RCT) to determine the effects of TRT on patient-important outcomes and adverse events in hypogonadal men. Data Sources: We searched Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Database of Systematic Reviews, Ovid Cochrane Central Register of Controlled Trials, and Scopus from inception to March 2th, 2017. Study selection: RCTs that assessed the efficacy and adverse events of TRT of at least 12 weeks compared with placebo in adult men with hypogonadism, defined by morning testosterone ≤300 ng/dL and at least one symptom or sign of hypogonadism. Data extraction: Reviewers working independently and in duplicate assessed the quality of the trials and collected data on patient characteristics, interventions, and outcomes. Data synthesis: We found 11 publications, reporting on 4 eligible trials (including 1,779 patients) at low risk of bias. Compared to placebo, TRT was associated with a small but significant increase in sexual desire or libido [standardized mean difference (SMD): 0.17, 95% CI 0.01, 0.34] (n=1383), erectile function [SMD: 0.16, 95% CI 0.06, 0.27] (n=1344), and sexual satisfaction [SMD: 0.16, 95% CI 0.01, 0.31] (n=676), but had no effect on energy or mood. TRT was associated with an increased risk of developing erythrocytosis [relative risk: 8.14, 95% CI: 1.87, 35.40] (n=1579) compared to placebo, but had no significant effect on lower urinary tract symptoms (LUTS). Conclusion: In hypogonadal men TRT improves sexual desire, erectile function, and sexual satisfaction, however it increases the risk of erythrocytosis. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Journal of Clinical Endocrinology and Metabolism
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Testosterone en_US
dc.subject Replacement Therapy en_US
dc.subject Hypogonadal Men en_US
dc.subject Systematic Review en_US
dc.title The efficacy and adverse events of testosterone replacement therapy in hypogonadal men: A systematic review and meta-analysis of randomized, placebo-controlled trials en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1210/jc.2018-00404
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18
dc.relation.issn 1945-7197


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