Morgentaler A, Lodaya K, Telang S, Hayashida DK, Hu Y. (2022). Comparison of patterns of use and clinical outcomes between injections of testosterone undecanoate and testosterone cypionate: an electronic health record cohort study. Androgens: Clinical Research and Therapeutics 3.1, 31–40, https://doi.org/10.1089/andro.2021.0024
Abstract
Background: Hypogonadism is characterized by low serum testosterone concentrations and the associated clinical manifestations (e.g., reduced libido, erectile dysfunction, and fatigue); testosterone therapy (TTh) is the primary treatment. This study compared treatment patterns and health outcomes in men using injection TTh with long-acting testosterone undecanoate (TU) injection versus short-acting testosterone cypionate (TC) injection.
Methods: A U.S. electronic health records (EHR) database was retrospectively reviewed to identify adult men who had TTh of TU or TC (index treatment) between January 1, 2014, and December 31, 2018, and ≥1 EHR within the 12 months before and 6 months after index treatment.
Results: There were 948 patients in the TU cohort and 121,852 in the TC cohort, of whom 419 and 86,219, respectively, were TTh-naive at index treatment. Hypogonadism diagnosis was documented in 81.1% and 58.8% of patients in the overall TU and TC cohorts, respectively. During the 1-year postindex period, higher adherence rates were observed in the TU versus TC cohort during months 7 through 12 (82.0% vs. 40.8%; p < 0.001), and a greater percentage of patients continued to receive TU (41.9%) versus TC (8.2%) for 12 months (p < 0.001). Variability in total testosterone levels was lower for TU versus TC in the TTh-naive population.
Conclusions: In this retrospective EHR study, men who received TU demonstrated a two-fold higher adherence, a five-fold improved maintenance on index TTh, and more stable testosterone levels at 1-year follow-up versus men who received TC. More consistent TTh use observed with TU may result in improved health outcomes for men with hypogonadism.