NIA funds national Testosterone Trial, Penn Medicine to lead

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Nov 2 2009University of Pennsylvania School of Medicine

Penn Medicine will lead a new national $45 million clinical trial to test whether testosterone therapy can favorably affect certain conditions affecting older men. Low serum testosterone may contribute to a number of problems affecting older men, including decreased ability to walk, loss of muscle mass and strength, decreased vitality, decreased sexual function, impaired cognition, cardiovascular disease and anemia. While testosterone normally decreases with age, in some men, low levels of testosterone may contribute to these debilitating conditions.

Led by the University of Pennsylvania School of Medicine and conducted at 12 sites across the nation, the Testosterone Trial will involve 800 men age 65 and older with low testosterone levels. The National Institute on Aging (NIA), part of the National Institutes of Health, is providing support for this large-scale clinical trial to evaluate the effect of testosterone therapy on older men.

The Testosterone Trial will include five separate studies. At each of the 12 sites, men 65 and older with low serum testosterone and at least one of the following conditions-anemia, decreased physical function, low vitality, impaired cognition or reduced sexual function-will be randomly assigned to participate in a treatment group or a control group. Treatment groups will be given a testosterone gel that is applied to the torso, abdomen, or upper arms; control groups will receive a placebo gel. Serum testosterone will be measured monthly for the first three months and quarterly thereafter up to one year. Participants will be tested on a wide range of measures to evaluate physical function, vitality, cognition, cardiovascular disease, and sexual function.

The University of Pennsylvania School of Medicine is the lead institution for the trial and will serve as coordinating center. Peter J. Snyder, M.D., Professor of Medicine in the Division of Endocrinology, Diabetes and Metabolism at Penn, is the principal investigator and will oversee trial activities. "This is an unprecedented opportunity for older men to learn more about themselves and at the same time help find out if testosterone will improve some of the afflictions of old age," said Dr. Snyder.

A 2004 report by the Institute of Medicine, "Testosterone and Aging: Clinical Research Directions," noted several important unanswered questions about the effects of testosterone therapy. Researchers aim to answer these questions by testing the effectiveness of testosterone therapy in older men with low testosterone levels and one of the following conditions: impaired walking, low vitality, sexual or cognitive dysfunction. A key consideration is the use of testosterone as a therapy for certain conditions, rather than as a preventive measure.

"This study is important because testosterone products have been marketed for many years as treatments for a variety of conditions," said Evan C. Hadley, M.D., director of NIA's Division of Geriatrics and Clinical Gerontology, which is the primary funder of the trial. "We hope this trial will establish whether testosterone therapy results in clear benefits for older men."

Recruitment of study participants began in October of 2009. Men age 65 and older who are interested in participating should call the site closest to them. Men living within a 50-mile radius of the study centers, listed below, are especially encouraged to participate.