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    Decision to use testosterone must be individualized

    Ajay Nehra, MDAjay Nehra, MD

    Testosterone replacement therapy has been much debated in recent months, in light of two studies linking the treatment to increased risk of all-cause mortality, myocardial infarction, and stroke, prompting an FDA investigation into TRT’s safety and widespread criticism from members of the urologic community. In this article, Ajay Nehra, MD, discusses those studies, evolving attitudes toward “low T,” and the importance of individualizing treatment. Dr. Nehra is professor and chair of urology and director of men’s health at Rush University Medical Center, Chicago. He serves as a consultant for Endo Pharmaceuticals. Dr. Nehra was interviewed by Urology Times Editorial Consultant Philip M. Hanno, MD, professor of urology at the University of Pennsylvania, Philadelphia.

    Q: Drug makers in the United States spent $3.47 billion on advertising directly to consumers last year, no doubt increasing health care costs significantly. Sales of prescription testosterone gels generated over $2 billion in American sales last year, a number that is expected to more than double by 2017. What is your gut feeling about direct-to-consumer advertising for testosterone supplements?

    A: Direct-to-consumer advertising has become the dominant pathway in addressing the expressive pharmaceutical growth in recent years. Clearly, direct-to-consumer advertising needs an assessment and probably understates the complexity of testosterone and the education that may be required.

    Related - FDA rejects petition for black box warning on T meds

    What is most important for us to appreciate is that while patients may be informed by direct-to-consumer advertising, they need to leave the final decisions on evaluation, diagnosis, and management to the urologist, the endocrinologist, the primary care physician.


    Next: A disease called "low T"

    Philip M. Hanno, MD, MPH
    Philip M. Hanno, a Urology Times editorial consultant, is professor of urology at the University of Pennsylvania, Philadelphia.


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