The study was not designed to determine whether testosterone therapy would prolong survival of men with heart failure, Iellamo said. "Future large trials are needed to appropriately evaluate the outcome," he said.
Such a multi-center trial is in the early planning stage, Iellamo noted. Meanwhile, his group is studying the effects of testosterone therapy in women. "Preliminary results seem promising," he added.
Men with heart failure who are tempted to try testosterone therapy on their own should avoid the temptation, he said. "It is absolutely contraindicated that patients choose testosterone, as well as all drugs, on their own," Iellamo said. The warning is especially important for men with high levels of prostate-specific antigen, an indicator of prostate cancer risk, he noted.
"This study confirms our previous finding for a beneficial effect of testosterone in men with moderate chronic heart failure, improving functional exercise capacity and insulin resistance," said Dr. T. Hugh Jones, a consultant endocrinologist at the University of Sheffield in England.
Jones and his colleagues have reported two studies with positive results, one using testosterone injections, the other using a hormone-delivering skin patch.
"Historically, testosterone-replacement therapy has been contraindicated in men with chronic heart failure," Jones said. "This was due to the fluid retention observed with older forms of testosterone preparation. This study, along with our studies, show that testosterone is safe in these patients and has a benefit on the underlying condition."
But the case for testosterone therapy in heart failure is far from proven, he said. "Now, longer-term studies evaluating effects on survival, quality of life and longer-term safety need to be done to establish if this treatment should be used routinely in the treatment of heart failure in men," Jones said.
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