Long-term treatment patterns of testosterone replacement medications

Area of Science:

• Endocrinology
• Urology
• Pharmacology

Background:

• Testosterone replacement therapy (TRT) aims to alleviate hypogonadism symptoms and improve health.
• Most men, however, do not adhere to TRT long-term.

Purpose of the Study:

• To evaluate long-term treatment patterns for hypogonadal men using topical TRT or short-lasting TRT injections.
• Analyze discontinuation and restart patterns for different TRT formulations.

Main Methods:

• Retrospective analysis of 15,435 topical TRT and 517 short-lasting TRT injection users from the Truven MarketScan Database (2009).
• Follow-up duration of 12 to 30 months post-treatment initiation.
• Defined treatment interruption as a medication gap >30 days; cyclic users restarted therapy after interruption.

Main Results:

• High discontinuation rates observed for both topical TRT and short-lasting TRT injections.
• After 3 months, 52% of topical TRT users and 31% of short-lasting TRT injection users remained on therapy.
• Cyclic users experienced 40-50% attrition per cycle, with decreasing gaps between stopping and restarting therapy over time.

Conclusions:

• Observed high discontinuation rates suggest TRT adherence is complex.
• Treatment patterns may be influenced by the hypogonadal disease state rather than TRT formulation or administration method.