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Comment & Response
September 2017

Meta-Epidemiology of Testosterone’s Risks and Benefits—Will We Ever Know the Answer?—Reply

Author Affiliations
  • 1Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, The University of Pennsylvania, Philadelphia
  • 2Center for Clinical Epidemiology & Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, The University of Pennsylvania, Philadelphia
JAMA Intern Med. 2017;177(9):1392-1393. doi:10.1001/jamainternmed.2017.2967

In Reply We disagree with Dr Haring’s statements that The Testosterone Trials (T-Trials)1-3 had low generalizability and showed some benefits in one area and some risks in others.

The goal of the T-Trials1-3 was to determine if testosterone treatment of symptomatic older men with low testosterone would be efficacious in any way. Toward this goal, we selected only men 65 years or older who had unequivocally low testosterone values. The median baseline testosterone level of 234 ng/dL confirms that the participants indeed had low testosterone levels. In addition, men had to have symptoms that could be ascribed to low testosterone. We included men with the comorbidities common at this age, although we did exclude men at high risk of conditions, such as prostate cancer, that testosterone might exacerbate. The results of the T-Trials1-3 are therefore highly generalizable to men 65 years and older who have low testosterone levels and symptoms that might motivate them to seek treatment.

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