Lee Jay, Brock Gerald, Barkin Jack, Bryson Nathan, Gronski Matthew A, Ormsby Ross
Department of Surgery, Division of Urology, University of Calgary, Calgary, AB, Canada.
Department of Surgery, Division of Urology, St. Joseph's Health Care, London, ON, Canada.
Can Urol Assoc J. 2019 Oct;13(10):301-306. doi: 10.5489/cuaj.5662.
Natesto, testosterone nasal gel (TNG), is a testosterone therapy (TTh) indicated for adult male hypogonadism. This study allowed titration decisions to be based on physicians' assessment of patient symptoms.
Hypogonadal males on active topical testosterone therapy (TThE) or naive to any form of testosterone therapy (TThN) were treated with 22 mg TNG daily (11 mg twice daily) for 90 days. Titration was determined by the physician at day 90 wherein the dose was increased to 33 mg daily if symptoms were not properly managed. Total testosterone (TT) levels were collected at day 90 and 120 and the quantitative Androgen Deficiency in the Aging Male (qADAM) symptom questionnaire was administered on days 0, 30, 60, 90, and 120.
At study endpoint, 77.0% of all patients were in the normal TT range. Mean qADAM scores increased from 30.8 at baseline to 35.5 (6.6) at day 90. Physician assessments resulted in 37% patients being up-titrated for an additional 30 days, however, qADAM scores did not change significantly at the higher dose.
The majority of patients achieved the normal range of testosterone with TNG when physicians based their titration decision on an assessment of symptoms. Sexual function and energy-related symptoms were predictive of improvements resulting from treatment. These symptoms were the most relevant indicators for physicians in making decisions relating to titration.
Natesto,即睾酮鼻用凝胶(TNG),是一种用于成年男性性腺功能减退的睾酮疗法(TTh)。本研究允许根据医生对患者症状的评估来做出滴定决策。
正在接受活性局部睾酮疗法(TThE)或未曾接受过任何形式睾酮疗法(TThN)的性腺功能减退男性,每天接受22毫克TNG治疗(每日两次,每次11毫克),持续90天。在第90天由医生确定滴定情况,若症状未得到妥善控制,则将剂量增加至每日33毫克。在第90天和第120天收集总睾酮(TT)水平,并在第0、30、60、90和120天进行老年男性雄激素缺乏定量(qADAM)症状问卷调查。
在研究终点,所有患者中有77.0%的人TT水平处于正常范围。qADAM平均得分从基线时的30.8增加到第90天的35.5(6.�)。医生评估导致37%的患者再滴定30天,然而,在较高剂量下qADAM得分没有显著变化。
当医生根据症状评估做出滴定决策时,大多数患者使用TNG达到了睾酮的正常范围。性功能和与能量相关的症状可预测治疗带来的改善。这些症状是医生在做出滴定决策时最相关的指标。