Testosterone use higher in men with CAD, despite risks

  • Morden NE & al.
  • JAMA Intern Med
  • 28 Dec 2018

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Analysis of Medicare fee-for-service administrative data indicates that testosterone use is higher in men with coronary artery disease (CAD) compared with men without CAD.

Why this matters

  • The FDA and Endocrine Society have issued safety warnings about increased cardiovascular risk associated with testosterone use.

Key results

  • Throughout the study period, testosterone use was consistently higher for men with CAD compared with men without CAD (2.0% vs 1.6% in 2016).
  • Off-label prescription testosterone use peaked in 2013 (3.2% of men with CAD; 2.4% of men without CAD).
  • The proportion of men with Part D prescription testosterone fills subject to prior authorization was 21% in 2012 and 49% in 2016.
  • In the 4 regions with the highest testosterone use, use ranged from 4.4% to 7.0% in 2016.
  • In the 14 regions with the lowest testosterone use, use ranged from 0.5% to 1.0% in 2016.

Study design

  • A 40% random sample of Medicare fee-for-service administrative data from January 1, 2007, to December 31, 2016, was used to generate an annual cohort of men aged ≥50 years who were analyzed for CAD status and testosterone use.
  • Funding: Agency for Healthcare Research and Quality Comparative Health System Performance Initiative.

Limitations

  • Use of claims data that may have inaccuracies.

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