Trends in Testosterone Replacement Therapy Use from 2003 to 2013 among Reproductive-Age Men in the United States
Trends in Testosterone Replacement Therapy Use from 2003 to 2013 among Reproductive-Age Men in the United States
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DOI：
10.1016/j.juro.2016.10.063
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发表时间：
2017-04-01
影响因子：
6.6
通讯作者：
Ross, Lawrence S.
中科院分区：
文献类型：
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作者：
Rao, Pravin Kumar;Boulet, Sheree L.;Ross, Lawrence S.
目的：虽然睾酮替代疗法在美国的使用在过去十年中急剧增加，但据我们所知，尚未对育龄男性使用睾酮替代疗法的趋势进行调查。我们评估了2003年至2013年18至45岁美国男性睾酮替代疗法使用和实践模式的变化，并将其与老年男性进行比较。材料和方法：这是个回顾展对参加Truven Health MarketScan（R）的18至45岁和56至64岁男性进行横断面分析2003年至2013年每个日历年的商业索赔数据库，包括2013年的5 094 868名男子。使用Poisson回归计算睾酮替代治疗的年使用率趋势。在睾酮替代疗法使用者中，Cochran-Armitage检验用于评估记录使用睾酮替代疗法前12个月内年龄、制剂类型、精液分析和血清睾酮水平测试的时间趋势。2003年至2013年期间，18至45岁男性的睾酮使用率增加了四倍，从29.2/10，000人年增加到118.1/10，000人-年（p < 0.0001）。在睾酮替代疗法使用者中，最初最常用的是局部凝胶制剂。2009年至2012年，注射剂的使用量翻了一番（分别为23.5%和46.2%），并在2013年超过了局部凝胶的使用量。在56至64岁的男性中，睾酮替代疗法的使用在统计学上显著增加了三倍。（p < 0.0001），这明显小于年轻男性的四倍增长（p < 0.0001）。结论：2003年至2013年，18至45岁男性使用睾酮替代疗法的人数增加了四倍，而老年男性增加了三倍。由于对生育力的影响和未知的长期后遗症，这一较年轻的年龄组应成为未来研究的重点。
Purpose: Although testosterone replacement therapy use in the United States has increased dramatically in the last decade, to our knowledge trends in testosterone replacement therapy use among reproductive-age men have not been investigated. We assessed changes in testosterone replacement therapy use and practice patterns among 18 to 45-year-old American men from 2003 to 2013 and compared them to older men.Materials and Methods: This is a retrospective, cross-sectional analysis of men 18 to 45 and 56 to 64 years old who were enrolled in the Truven Health MarketScan (R) Commercial Claims Databases throughout each given calendar year from 2003 to 2013, including 5,094,868 men in 2013. Trends in the yearly rates of testosterone replacement therapy use were calculated using Poisson regression. Among testosterone replacement therapy users, the Cochran-Armitage test was used to assess temporal trends in age, formulation type, semen analysis and serum testosterone level testing during the 12 months preceding the documented use of testosterone replacement therapy.Results: Between 2003 and 2013, there was a fourfold increase in the rate of testosterone use among 18 to 45-year-old men from 29.2/10,000 person-years to 118.1/10,000 person-years (p < 0.0001). Among testosterone replacement therapy users, topical gel formulations were initially most used. Injection use then doubled between 2009 and 2012 (23.5% and 46.2%, respectively) and surpassed topical gel use in 2013. In men 56 to 64 years old there was a statistically significant threefold increase in testosterone replacement therapy use (p < 0.0001), which was significantly smaller than the fourfold increase in younger men (p < 0.0001).Conclusions: In 2003 to 2013, testosterone replacement therapy use increased fourfold in men 18 to 45 years old compared to threefold in older men. This younger age group should be a focus for future studies due to effects on fertility and unknown long-term sequelae.