Effect of Testosterone on Asthma Exacerbations

Epidemiologic studies have suggested that serum testosterone (T) concentrations are inversely related to asthma prevalence as well as exacerbations in men. It is not known if testosterone therapy (TTh) and androgen deprivation therapy (ADT) have any effect on asthma exacerbations.

This is a retrospective study conducted in the electronic health records of a tertiary hospital database. We included adult men with asthma who had received either TTh or ADT. Asthma exacerbation was defined as hospitalization due to asthma or usage of oral prednisone if exacerbation was treated in the outpatient setting.

The study included 229 men who had received TTh (mean age 60 ± 12 years, body mass index 34 ± 7 kg/m²) and 93 men who had received ADT (mean age 75 ± 8 years, body mass index 31 ± 7 kg/m²). Patients took TTh for a median of 5.3 (IQR 2.4, 9.1) years. The rate of asthma exacerbations per 1,000 patient-years before TTh and on TTh was similar (96.4 [95% CI 75.2, 121.8] before vs 87.2 [95% CI 66.2, 112.8] after, rate ratio = 1.1 [95% CI 0.0, 1.5], P = .70). Results were similar in ADT group. Patients took ADT for median time of 2.05 (IQR 1.0, 4.0) years. The rate of asthma exacerbations before ADT and during ADT was similar (60.44 [95% CI 40.8, 86.3] vs 58.3 [95% CI 30.1, 101.8] respectively, rate ratio = 1.0 [95% CI 0.0, undefined], P = .50).

Our study shows that TTh or ADT in men with asthma is not associated with a change in asthma exacerbations. These data are informative since hypogonadism, prostate cancer, and asthma are commonly encountered comorbidities in the ambulatory setting.