Clinicians should consider testosterone deficiency in their male patients with COPD, according to Australian researchers whose meta-analytic results found that testosterone levels were significantly lower in men with COPD than in healthy controls. They noted, however, that there is “insufficient evidence to draw firm conclusions about the long-term benefits and risks of testosterone therapies.”

After analyzing data from 15 studies, 9 observational studies of endogenous testosterone levels in COPD patients and 6 randomized controlled trials of testosterone therapy in patients with COPD, the team found that active testosterone therapy significantly improved standardized peak muscle and peak workload. However, testosterone therapy did not improve peak oxygen uptake or health-related quality of life outcomes.

According to the authors, testosterone therapy was associated with an excess of serious adverse events, including COPD exacerbations and respiratory failure compared with controls.

“Reliable information on the efficacy and safety – as well as cost-effectiveness – of specific testosterone therapies is required to inform clinical practice guidelines for COPD,” the authors concluded.