Effect of 12-months testosterone replacement therapy on bone mineral density and markers of bone turnover in testicular cancer survivors - results from a randomized double-blind trial.

Testicular cancer bone mineral density hypogonadism late effects markers of bone turnover osteoporosis testosterone

Journal

Acta oncologica (Stockholm, Sweden)
ISSN: 1651-226X
Titre abrégé: Acta Oncol
Pays: England
ID NLM: 8709065

Informations de publication

Date de publication:
Jul 2023
Historique:
medline: 28 8 2023
pubmed: 8 5 2023
entrez: 8 5 2023
Statut: ppublish

Résumé

Testicular cancer survivors (TCS) are at risk of Leydig cell insufficiency, which is a condition characterized by elevated luteinising hormone (LH) in combination with low levels of testosterone. It has been suggested that this condition is associated with impaired metabolic profile and low bone mineral density (BMD). The primary aim of the randomized double-blind trial NCT02991209 was to evaluate metabolic profile after 12-months testosterone replacement therapy (TRT) in TCS with mild Leydig cell insufficiency. Here we present the secondary outcomes of changes in BMD and markers of bone turnover. In total, 69 TCS with mild Leydig cell insufficiency were randomized 1:1 to 12 months TRT ( After 12 months treatment, TRT was not associated with a statistically significant difference in BMD compared to placebo; total body BMD: 0.01 g/cm2 (95% confidence interval (CI): -0.01 - 0.02), BMD of the lumbar spine: 0.01 g/cm2, (95% CI: -0.01-0.03), BMD of the left femoral neck: 0.00, (95% CI: -0.01-0.02). TRT was associated with a small but statistically significant increase in P1NP: 11.65 µg/L (95% CI: 3.96, 19.35), while there was no difference in CTX. 12 months of TRT did not change BMD, while there was as small and clinically irrelevant increase in P1NP compared to placebo in TCS with mild Leydig cell insufficiency. The findings need validation in a larger cohort.

Sections du résumé

BACKGROUND UNASSIGNED
Testicular cancer survivors (TCS) are at risk of Leydig cell insufficiency, which is a condition characterized by elevated luteinising hormone (LH) in combination with low levels of testosterone. It has been suggested that this condition is associated with impaired metabolic profile and low bone mineral density (BMD). The primary aim of the randomized double-blind trial NCT02991209 was to evaluate metabolic profile after 12-months testosterone replacement therapy (TRT) in TCS with mild Leydig cell insufficiency. Here we present the secondary outcomes of changes in BMD and markers of bone turnover.
METHODOLOGY UNASSIGNED
In total, 69 TCS with mild Leydig cell insufficiency were randomized 1:1 to 12 months TRT (
RESULTS UNASSIGNED
After 12 months treatment, TRT was not associated with a statistically significant difference in BMD compared to placebo; total body BMD: 0.01 g/cm2 (95% confidence interval (CI): -0.01 - 0.02), BMD of the lumbar spine: 0.01 g/cm2, (95% CI: -0.01-0.03), BMD of the left femoral neck: 0.00, (95% CI: -0.01-0.02). TRT was associated with a small but statistically significant increase in P1NP: 11.65 µg/L (95% CI: 3.96, 19.35), while there was no difference in CTX.
CONCLUSION UNASSIGNED
12 months of TRT did not change BMD, while there was as small and clinically irrelevant increase in P1NP compared to placebo in TCS with mild Leydig cell insufficiency. The findings need validation in a larger cohort.

Identifiants

pubmed: 37151105
doi: 10.1080/0284186X.2023.2207218
doi:

Substances chimiques

Testosterone 3XMK78S47O
Biomarkers 0

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

689-695

Auteurs

P L Jørgensen (PL)

Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

M Kreiberg (M)

Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

N Jørgensen (N)

Department of Growth and Reproduction, Copenhagen University hospital - Rigshospitalet, Copenhagen, Denmark.
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University hospital - Rigshospitalet, Copenhagen, Denmark.

A Juul (A)

Department of Growth and Reproduction, Copenhagen University hospital - Rigshospitalet, Copenhagen, Denmark.
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University hospital - Rigshospitalet, Copenhagen, Denmark.
Department Clinical Medicine, University of Copenhagen, Denmark.

P S Oturai (PS)

Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

C Dehlendorff (C)

Statistics and Dataanalysis, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.

J Lauritsen (J)

Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

T Wagner (T)

Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

J Rosenvilde (J)

Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

G Daugaard (G)

Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Department Clinical Medicine, University of Copenhagen, Denmark.

C R Medici (CR)

Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

N R Jørgensen (NR)

Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

M Bandak (M)

Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

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Classifications MeSH