KANSAS CITY, MO—With testosterone replacement therapy (TRT) prescriptions increasing several-fold in the last decade, concerns have been raised about a possible increased incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE).
Because data is lacking on the association between TRT and DVT/ PE, Kansas City VAMC researchers and colleagues designed a study to evaluate the incidence of those conditions in men who were prescribed TRT for low serum total testosterone levels (sTT). The results were published online by the journal Chest.1
The retrospective cohort study used data obtained from the VA Informatics and Computing Infrastructure (VINCI) to compare the incidence of DVT/PE between those who received TRT and subsequently had normal on-treatment sTT levels (Gp1), those who received TRT but continued to have low on-treatment sTT (Gp2) and those who did not receive TRT (Gp3). Excluded from the study were patients with prior history of DVT/PE, cancer, hypercoagulable state and chronic anticoagulation.
With the final cohort consisting of 71,407 subjects with low baseline sTT, 10,854 did not receive TRT (Gp3), and 60,553 received TRT. Of those who received TRT, 38,362 achieved normal sTT (Gp1), while 22,191 continued to have low sTT (Gp2).
Results indicated that the incidence of DVT/PE was 0.5%, 0.4% and 0.4% in Gp1, Gp2 and Gp3, respectively. Analysis showed no statistically significant difference in DVT/PE free survival between different groups, according to the report.
“This study did not detect a significant association between testosterone replacement therapy and risk of DVT/PE in adult men with low sTT who were at low-moderate baseline risk of DVT/PE,” researchers concluded.
1 Sharma R, Oni OA, Chen G, Sharma M, et. al. Association between Testosterone Replacement Therapy and the Incidence of Deep Vein Thrombosis and Pulmonary Embolism: A Retrospective Cohort Study of the Veterans Administration Database. Chest. 2016 May 11. pii:S0012-3692(16)49000-8. doi: 10.1016/j.chest.2016.05.007. [Epub ahead of print] PubMed PMID: 27179907.