Manhattan Medical Research, New York, New York.
Lahey Hospital and Medical Center, Burlington, Massachusetts.
J Urol. 2019 Mar;201(3):587-594. doi: 10.1016/j.juro.2018.09.057.
In this open label, single arm, dose blinded, 52-week registration phase study we evaluated the efficacy and safety of a subcutaneous testosterone enanthate auto-injector administered weekly to men with hypogonadism.
A total of 150 patients were initiated on a 75 mg subcutaneous testosterone enanthate auto-injector self-administered weekly. Dose adjustments were made at week 7 to 50, 75 or 100 mg testosterone enanthate based on the week 6 total testosterone trough concentration. If required, dose adjustments continued through the extended treatment phase. Pharmacokinetic and clinical laboratory parameters, treatment emergent adverse events and injection site reactions were captured.
The primary end point was met since 92.7% of patients achieved an average total testosterone concentration of 300 to 1,100 ng/dl (mean ± SD 553.3 ± 127.29) at week 12. A maximum concentration of less than 1,500 ng/dl was achieved by 91.3% of patients and no patient had a level greater than 1,800 ng/dl at week 12. The mean total testosterone trough concentration was 487.2 ± 153.33 ng/dl at week 52. Of the patients more than 95% reported no injection related pain. The most frequently reported treatment emergent adverse events were increased hematocrit, hypertension and increased prostate specific antigen, which led to discontinuation in 30 men. There were no study drug related serious adverse events.
The dose adjusted subcutaneous testosterone enanthate auto-injector demonstrated a steady serum total testosterone pharmacokinetic profile with small peak and trough fluctuations. The device was safe, well tolerated and virtually painless, indicating that this subcutaneous testosterone enanthate auto-injector offers a testosterone delivery system that is a convenient weekly option to treat testosterone deficiency.
在这项开放标签、单臂、剂量盲法、52 周注册期研究中,我们评估了每周皮下注射一次睾酮庚酸酯自动注射器治疗性腺功能减退症男性的疗效和安全性。
总共 150 名患者开始使用 75 毫克皮下睾酮庚酸酯自动注射器,每周自行注射一次。根据第 6 周总睾酮低谷浓度,在第 7 周将剂量调整为 50、75 或 100 毫克睾酮庚酸酯。如果需要,通过扩展治疗阶段继续调整剂量。记录药代动力学和临床实验室参数、治疗中出现的不良事件和注射部位反应。
主要终点达到,因为 92.7%的患者在第 12 周时平均总睾酮浓度达到 300 至 1100ng/dl(平均值±SD 553.3±127.29)。91.3%的患者达到了小于 1500ng/dl 的最大浓度,而第 12 周时没有患者的浓度大于 1800ng/dl。第 52 周时,平均总睾酮低谷浓度为 487.2±153.33ng/dl。超过 95%的患者报告无注射相关疼痛。报告最频繁的治疗中出现的不良事件是红细胞压积增加、高血压和前列腺特异性抗原增加,导致 30 名患者停药。无研究药物相关严重不良事件。
经剂量调整的皮下睾酮庚酸酯自动注射器显示出稳定的血清总睾酮药代动力学特征,峰值和低谷波动较小。该装置安全、耐受良好且几乎无痛,表明这种皮下睾酮庚酸酯自动注射器提供了一种睾酮输送系统,是治疗睾酮缺乏症的一种方便的每周选择。