在男性低雄性恋患者的丸激素替代疗法期间发生的前列腺安全事件:一项随机临床试验
Shalender Bhasin1, Thomas G Travison2, Karol M Pencina1
1Research Program in Men's Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
JAMA network open
|December 27, 2023
概括
替代疗法 (TRT) 并没有显著增加前列腺癌或其他前列腺不良事件的风险. 这项研究为有关TRT安全的明智决策提供了关键数据.
科学领域:
- 内分泌学 在内分泌学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
背景情况:
- 替代疗法 (TRT) 对前列腺健康的影响仍然是一个重要的临床问题.
- 低阴腺男性经常考虑TRT,需要清楚地了解潜在的前列腺相关风险.
研究的目的:
- 评估TRT与安慰剂相比对高度前列腺癌和其他前列腺不良事件的发病率的影响.
- 评估风险,包括任何前列腺癌,急性尿路滞留,和侵袭性前列腺手术在男性.
主要方法:
- 这是一项双盲,安慰剂控制的随机临床试验,涉及5246名患有心血管疾病或心血管疾病风险的男性 (年龄在45-80岁).
- 参与者接受了局部1.62%的丸激素凝或安慰剂,分层对先前的心血管疾病.
- 主要终点是高度前列腺癌发病率;次要终点包括任何前列腺癌,尿路保留和侵入性手术.
主要成果:
- 在14304人年中,高度前列腺癌发病率为TRT的0.19%,与安慰剂的0.12%相比 (HR,1.62;P=.51),没有显著差异.
- 任何前列腺癌,急性尿,侵入性手术和前列腺活检的发病率在各组之间也相似.
- 丸激素治疗导致PSA度增加,但没有显著改变国际前列腺症状得分.
结论:
- 在精心挑选的男性中,TRT并没有增加前列腺癌或其他前列腺不良事件的风险.
- 这些发现支持对TRT的潜在风险和好处进行更明智的评估.
- 在这两组中前列腺事件的发病率很低,这凸显了基线查的重要性.
相关概念视频
01:20Disorders of the Male Reproductive System
421
Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
421
01:26Testosterone: Functions and Regulation
670
The intricate hormonal interplay essential for male reproductive health begins with the release of gonadotropin-releasing hormone (GnRH) by the hypothalamus. This hormone prompts the pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). LH targets the Leydig cells in the testes, stimulating them to produce and release testosterone. In concert with testosterone, FSH acts on the Sertoli cells within the seminiferous tubules to facilitate the release of...
670
01:28Menopause
166
Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
166
01:12Hazard Ratio
129
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
For example, in a clinical trial...
129
01:23Infertility in Males
267
Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...
267
01:17Male Sexual Response: Erection & Ejaculation
2.4K
Sexual stimulation can take various forms, such as physical touch and visual or auditory cues. When this happens, the parasympathetic reflex in the sacral portion of the spinal cord is activated. This reflex stimulates the release of nitric oxide (NO), which then dilates the arterioles in the penis, increasing blood flow to the erectile tissues - the corpora cavernosa and corpus spongiosum.
The blood filling the erectile tissues compresses the veins, which helps to prevent blood from leaving...
The blood filling the erectile tissues compresses the veins, which helps to prevent blood from leaving...
2.4K