Effects of Testosterone Replacement Therapy in Men With COPD

Testosterone replacement therapy (TRT) may slow disease progression in men with chronic obstructive pulmonary disease (COPD) according to a study published in Chronic Respiratory Disease.  

Investigators conducted a large-scale nationally representative retrospective study to assess whether TRT reduced the risk for hospitalizations in men with COPD. They looked at 2 cohorts: 1 from the Clinformatics Data Mart (CDM) database and the other from the national 5% Medicare database. The CDM cohort identified 450 men aged 40 to 63 years who were diagnosed with COPD between January 1, 2004 and December 31, 2014, who initiated TRT within 12 months of their first diagnosis and who had complete enrollment ≥12 months before and after their testosterone initiation date. In the Medicare cohort, 253 men older than 66 years and diagnosed with COPD between January 1, 2007 and December 31, 2012 were identified with the same TRT criteria.  

Investigators compared pre- vs post-respiratory hospitalization rates in TRT users vs matched TRT nonusers over a comparable time period. This difference in differences analysis showed that TRT users had a larger relative reduction in respiratory hospitalizations. Middle-aged TRT users in the CDM cohort had a 4.2% greater reduction compared with TRT nonusers (–2.4 decrease vs 1.8 increase, P =.03). Furthermore, older TRT users in the Medicare cohort had a 9.1% greater reduction in respiratory hospitalizations compared with TRT nonusers (–0.8 decrease vs 8.3 increase, P =.04).  

The study had several limitations. First, diagnoses were determined solely based on ICD-9-CM codes, which may have led to data misclassification. Second, the investigators did not include information about the coadministration of drugs. Third, the study did not account for confounding factors such as diet, alcohol use, and other behaviors that may have affected COPD disease progression. Fourth, the cohorts studied were relatively small. Finally, the study included dates for when TRT prescriptions were filled, but not when they were obtained by the patient.

These findings indicate that TRT may slow disease progression in men with COPD. Further research is necessary to understand the biological pathways involved. 

Disclosures: Dr Baillargeon reports financial relationships with AbbVie, Endo Pharmaceuticals, GlaxoSmithKline, and Auxilium Pharmaceuticals.

Reference

Baillargeon J, Urban RJ, Zhang W, et al. Testosterone replacement therapy and hospitalization rates in men with COPD [published online September 11, 2018]. Chron Resp Dis. doi:10.1177/1479972318793004