Testosterone treatment in long-term opioid users with testosterone deficiency leads to better outcomes

  • Jasuja GK & al.
  • JAMA Netw Open
  • 02.12.2019

  • von Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Receiving testosterone therapy plus opioids was associated with significantly lower rates of all-cause mortality and lower incidence of major adverse cardiovascular events (MACE), femoral or hip fractures, and anemia during a 6-year period vs receiving opioids alone in men with long-term opioid use and testosterone deficiency.

Why this matters

  • Prescription opioid use is associated with testosterone deficiency, but there are few data on the outcomes of testosterone treatment in long-term opioid users.

Study design

  • A nationwide cohort study on male long-term opioid users with testosterone deficiency (n=21,272).
  • Funding: Department of Veterans Affairs; others.

Key results

  • 14,121 individuals received testosterone; 7151 individuals did not.
  • Opioid users who received testosterone vs those without testosterone were more likely to have:
    • obesity (49.0% vs 43.7%; P<.001 and>
    • hyperlipidemia (48.8% vs 43.0%; P<.001>
  • However, individuals who received testosterone vs those who did not receive had a lower prevalence of:
    • coronary artery disease (12.9% vs 15.9%; P<.001 and>
    • stroke (1.3% vs 2.4%; P<.001>
  • Opioid users who received testosterone had significantly lower risks for:
    • all-cause mortality (aHR, 0.51; 95% CI, 0.42-0.61),
    • MACE (aHR, 0.58; 95% CI, 0.51-0.67),
    • femoral/hip fractures (aHR, 0.68; 95% CI, 0.48-0.96), and
    • anemia (aHR, 0.73; 95% CI, 0.68-0.79).

Limitations

  • Observational design.

Coauthored with Chitra Ravi, MPharm