LOS ANDROGENOS TRANSDERMICOS SON UTILES PARA LOS ANCIANOS CON HIPOGONADISMO

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La testosterona transdérmica puede administrarse a hombres de edad avanzada con concentraciones séricas de testosterona hipogonádicas y síntomas compatibles con deficiencia de andrógenos.
Autor:
Niloufar Ilani
Columnista Experto de SIIC

Institución:
Harbor-UCLA Medical Center


Artículos publicados por Niloufar Ilani
Coautores
Christina Wang* Ronald S Swerdloff* 
MD, Harbor-UCLA Medical Center, Torrance, EE.UU.*
Recepción del artículo
12 de Diciembre, 2007
Aprobación
28 de Enero, 2008
Primera edición
13 de Febrero, 2009
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Los geles de testosterona transdérmica han probado ser un medio eficaz para administrar testosterona a hombres con hipogonadismo. Se han utilizado parches, geles y cremas en formulaciones de testosterona transdérmica. Los parches presentaban problemas con la adherencia o la irritabilidad cutánea. Los geles tienen una farmacocinética favorable, poca irritabilidad cutánea y han sido bien recibidos por médicos y usuarios; sin embargo, presentan el problema potencial de la transferencia del hombre a la mujer o a los hijos. Sería conveniente contar con más datos basados en estudios correctamente controlados y bien diseñados que muestren que los hombres de edad avanzada con hipogonadismo responden tan bien como los más jóvenes a la terapia con testosterona según todos los criterios de valoración. No obstante, los datos disponibles sobre los efectos de la testosterona en tejido adiposo, músculo y hueso indican que la edad no impide la respuesta. Por lo tanto, es nuestra opinión que la testosterona transdérmica puede administrarse a hombres de edad avanzada con concentraciones séricas de testosterona hipogonádicas y síntomas compatibles con una deficiencia de andrógenos. El rápido tiempo de consumo tanto de los parches como los geles, en comparación con los preparados de testosterona inyectables de acción prolongada, puede proporcionar una modalidad terapéutica preferida en los hombres de edad avanzada, quienes debido a su edad pueden correr mayor riesgo de eventos adversos, como el cáncer de próstata que responde a los andrógenos.

Palabras clave
testosterona, andrógenos, hipogonadismo, transdérmico, geles


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Abstract
Transdermal testosterone gels have proven to be an efficacious means of delivering testosterone to hypogonadal men. Patches, gels and creams have been used in testosterone transdermal formulations. Patches suffered from problems either with adherence or skin irritability. Gels have favorable pharmacokinetics, little skin irritability and have been well received by clinicians and users; however, they have a potential problem of transfer from male patient to female partner or children. More data based on properly controlled and powered studies showing that older hypogonadal men respond as well as younger hypogonadal men to testosterone therapy across all endpoints would be desirable. .Nevertheless, the available data on T effects on fat, muscle and bone indicate that age does not prevent responsiveness. Thus, in the authors' opinions transdermal testosterone may be administered to older men with hypogonadal serum T levels and symptoms consistent with androgen deficiency. The rapid off time of both patches and gels as compared to long acting injectable testosterone preparations may provide a preferred treatment modality for older men who because of age may have a potential higher risk of adverse events including androgen responsive prostate cancer.

Key words
testosterone, androgen, hypogonadism, transdermal, gels


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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Endocrinología y Metabolismo, Urología
Relacionadas: Farmacología, Geriatría, Medicina Farmacéutica, Medicina Interna



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Enviar correspondencia a:
Ronald S. Swerdloff, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, CA 90502, 1124 West Carson Street, Torrance, EE.UU.
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