Introduction

Determine the association of Testosterone Replacement Therapy (TRT) with event free survival and absolute risk of hepatotoxicity, thromboembolic cardiovascular events, and obstructive sleep apnea (OSA) in a cohort of healthy adult men using TRT.

Methods

We queried the TRICARE military database, which comprises all retired and active duty men and women and their immediate family members, who receive insurance through the military. Men age 18-65, diagnosed with hypogonadism who received TRT between 2006-2010 were included. We compared event-free survival and absolute risk of hepatotoxicity, thromboembolic and cardiovascular events, and obstructive sleep apnea (OSA) between men using TRT and controls._x000D_

Results

Relative to controls, patients using TRT had improved cardiovascular event free survival (p=0.004). There was no significant difference in event free survival for hepatotoxicity (p=0.345), and thromboembolic events (p=0.239). Absolute two-year risk for men using TRT was 0.02 for hepatotoxicity, 0.06 for Cardiac events, 0.02 for thromboembolic events and 0.17 for Sleep Apnea. Absolute 2-year risk was similar with the exception with OSA, which had higher 2-year absolute risk (95% CI: 1.56%-1.84% of TRT users vs. 1.1%-1.4% in controls).

Conclusions

In our cohort of there was no significant increase in risk of hepatotoxicity, and thromboembolic complications among men using TRT. Additionally, men using TRT had modestly prolonged cardiovascular_x000D_ event-free survival. Prior studies suggesting elevated risk of cardiovascular effects may be less generalizable to healthy young men using TRT in a community setting.

Funding

none