Long-term testosterone undecanoate treatment in the elderly testosterone deficient male: An observational cohort study.

Elderly patients required dose interval adjustments 44% more often than younger patients, with intervals prolonged 4% more in elderly patients.

• Increasing intervals between TU injections were performed 44% more often in the elderly compared to younger patients
• Time between TU injections were prolonged 4% more in the elderly patients
• Treatment targets included free testosterone between 0 and -1 SD from the age-adjusted mean, no symptoms of testosterone deficiency, and hematocrit within the normal range
• TU dose was adjusted yearly through shortening or prolongation of time between injections

Polycythemia occurred in 40% of patients during follow-up, with no difference in risk between age groups.

• 40% of patients — both elderly and younger — experienced polycythemia during follow-up
• Risk of polycythemia did not differ with age
• The study population consisted of 63 elderly and 63 younger patients
• Median follow-up time during testosterone replacement was 12.1 years

Hematocrit and the hematocrit-to-testosterone ratio increased with treatment time but did not differ between age groups.

• The hematocrit, as well as the hematocrit for a given serum testosterone (hematocrit:testosterone ratio), increased with treatment time
• These measures did not differ between elderly and younger patient groups
• Elderly patients were born before 1956 and younger patients between 1965 and 1985

The study was a single-center longitudinal observational cohort of testosterone-deficient patients treated with long-acting intramuscular testosterone undecanoate between 2005 and 2010.

• Patients who initiated long-acting TU treatment between 2005 and 2010 were included
• The study population consisted of 63 elderly and 63 younger patients
• Median follow-up time during testosterone replacement was 12.1 years
• Quarterly intramuscular injections with long-acting testosterone undecanoate were used, providing stable serum testosterone concentrations over time

Long-acting testosterone undecanoate treatment in elderly testosterone-deficient patients is feasible and not associated with increased adverse outcomes compared to younger patients when age-adjusted targets are used.

• Use of long-acting TU in elderly patients has been limited due to lack of safety and feasibility studies
• TU treatment in elderly testosterone-deficient patients is not associated with an increased risk of polycythemia compared to younger patients if age-adjusted treatment targets are reached
• Treatment targets were age-adjusted, with free testosterone targeted between 0 and -1 SD from the age-adjusted mean