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Elderly women with heart failure may benefit from testosterone therapy

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Results of a small study indicate that transdermal testosterone improves functional capacity and other parameters in elderly women with chronic heart failure.

Writing in the October 12 issue of the Journal of the American College of Cardiology, Dr. Ferdinando Iellamo at the University of Rome “Tor Vergata,” Italy, and colleagues note that a recent study by their group, as well as other studies, have shown that testosterone supplementation improves muscle strength and ventilatory efficiency in elderly men with moderately severe CHF.

The team’s current proof-of-concept study aimed to find out if elderly women with CHF might also benefit from low-dose testosterone supplementation. To that end, 36 such women were randomized 2-to-1 to receive transdermal patch testosterone 300 mcg or placebo patch applied twice a week for 24 weeks, in addition to optimal medical therapy.

The 6-minute walk test improved significantly by 97 meters (from 260 to 357 meters) in the testosterone group, but by only 36 meters in the placebo group, according to the report.

“New York Heart Association functional class improved from III to II in 7 of 20 patients in the testosterone group and in 2 of 12 in the placebo group (p= 0.03),” the researchers found.

Insulin resistance decreased in the testosterone group but increased among those given placebo (-0.57 vs. 0.17 by HOMA, respectively), and muscle strength measured by peak torque increased significantly with testosterone compared with placebo.

“No sign of virilization was detected in the testosterone group at intermediate and final visits, and patients did not report adverse effects related to testosterone administration,” Dr. Iellamo and colleagues report.

They conclude, “The results show that physiological testosterone replacement therapy improves functional capacity and insulin resistance in women with CHF.”

In an accompanying editorial, Dr. Paul W. Armstrong and Justin A. Ezekowitz of the University of Alberta, Edmonton, Canada, say the study represents a promising start for this new therapeutic approach. “However, we have travelled down the path of potential new treatments for heart failure many times and been disappointed more often than pleased.”

Still, Dr. Armstrong added in comments to Reuters Health, “I think the ultimate role (of testosterone supplementation) in CHF remains promising but now requires a larger study in men and women with appropriate selection and dosing over a longer time with valid clinical endpoints.”

Reference:

Testosterone Therapy in Women With Chronic Heart Failure: A Pilot Double-Blind, Randomized, Placebo-Controlled Study

J Am Coll Cardiol 2010; 56:1310–1316.