In Reply We do not agree with Dr Dhindsa and colleagues that the increase in noncalcified plaque volume was confined to the fibrous component. Changes in that component did reach statistical significance, but changes in the other noncalcified plaque components were also greater in the testosterone group, although they did not reach statistical significance (P values of .11 and .14). Thus, the results for all 3 components were consistent.
Dhindsa and colleagues also ask whether results were driven by large changes in plaque volume in a few men in the testosterone group. This was not the case. The proportion of men in the testosterone group whose noncalcified plaque volume increased during the 1 year of the trial was 70%, compared with 54% of men in the placebo group, whereas the proportions showing a decrease in noncalcified plaque volume were 27% in the testosterone group and 45% in the placebo group. Only 2 men in the testosterone group had larger changes than the largest change in the placebo group, and those changes were not markedly larger.
Budoff MJ, Ellenberg SS, Snyder PJ. Changes in Coronary Artery Plaque With Testosterone Therapy—Reply. JAMA. 2017;317(23):2451. doi:10.1001/jama.2017.6024