SAN FRANCISCO — Long-term treatment with testosterone undecanoate was associated with reduced cardiovascular (CV) morbidity and mortality in patients with hypogonadism and type 2 diabetes, according to study results presented at the American Diabetes Association 79th Scientific Sessions, held June 7 to 11, 2019, in San Francisco, California.

As there is controversy regarding the CV effects of testosterone treatment, the investigators aimed to assess the morbidity and mortality rates associated with testosterone undecanoate treatment in men with hypogonadism and type 2 diabetes.

The researchers identified 823 men with hypogonadism, including 324 (39%) with type 2 diabetes. Of these, 152 received testosterone undecanoate 1000 mg/12 weeks (intervention group: mean age, 61.8 ± 5.1 years; mean follow-up, 7.4 years) and 172 declined treatment (control group: mean age, 63.6 ± 4.9 years; mean follow-up, 8.3 years).

In the intervention group, 54 patients (35.5%) had a preexisting CV disease (myocardial infarction, stroke, or diagnosis of carotid artery disease), as did 68 patients (39.5%; P =.4574) in the control group.

Smoking rates were similar in both groups (42.1% and 38.4% for intervention vs control, respectively; P =.4939) and there was no difference in high-density lipoprotein levels. However, the other classical CV risk factors were more common in the intervention group, including higher body mass index (36.4 ± 4.5 kg/m2 vs 33.3 ± 5.3 kg/m2), systolic blood pressure (162.6 ± 13.1 mm Hg vs 145.4 ± 14.7 mm Hg), diastolic blood pressure (97.2 ± 10.7 mm Hg vs 84.7 ± 10.3 mm Hg), and low-density lipoprotein (4.6 ± 0.7 mmol/L vs 4.0 ± 1.4 mmol/L) compared with the control group.

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In addition, glycemic control was better in the control group (mean hemoglobin A1c, 9.1% ± 1.2% in the intervention group vs 7.8% ± 0.7% in the control group; homeostatic model assessment for insulin resistance, 10.2 ± 2.1 vs 7.5 ± 1.3, respectively).

During the follow-up period, mortality rates were significantly higher in the control group (43 patients; 25%) compared with the intervention group (12 patients; 7.8%; P <.0001). As for CV morbidity, the intervention group had no documented cases of myocardial infarction or stroke, while in the control group there were 49 cases (28.5%) of myocardial infarction and 42 strokes (24.4%).

“Mortality, myocardial infarctions and strokes were reduced in men with hypogonadism and [type 2 diabetes] receiving long-term testosterone therapy,” concluded the researchers.

Disclosures: Multiple authors disclosed associations with the pharmaceutical industry. Please see the original abstract for a full list of authors’ disclosures.

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Reference

Haider KS, Haider A, Saad F. Reduction of mortality and major adverse cardiovascular events (MACE) in men with hypogonadism and type 2 diabetes (T2DM) receiving long-term treatment with injectable testosterone undecanoate (TU): ten-year data from a urological registry study. Presented at: American Diabetes Association 79th Scientific Sessions; June 7-11, 2019; San Francisco, CA. Poster 1123-P.