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Testosterone therapy for thrombophilia likely linked to increased risk of osteonecrosis
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Results of this study indicated an association between the use of testosterone therapy in patients with thrombophilia and an increased risk for osteonecrosis.
Researchers studied 16 patients who developed osteonecrosis after the use of testosterone therapy. These patients were compared with 110 healthy control patients without osteonecrosis and 48 control patients who had not received testosterone therapy, but had developed osteonecrosis. Investigators measured thrombophilia factors including Factor V Leiden, prothrombin, hypo brinolysis, Factors VIII, Factors XI, anticardiolipin antibody immunoglobulin G, immunoglobulin M and homocysteine. With electrochemiluminescence immunoassay, investigators measured total testosterone levels and estradiol levels.
Results showed all of the 16 patients had idiopathic osteonecrosis. Of these patients, 10 had developed osteonecrosis within 6 months of beginning testosterone therapy. Five of the 16 patients were Factor V Leiden heterozygotes compared with two of the 109 participants in the healthy control group and four of the 48 patients with osteonecrosis. High factor VIII levels were seen in four of the 16 patients with osteonecrosis after testosterone therapy compared with seven of the healthy control patients.
According to researchers, 14 of the 16 patients with osteonecrosis and 47 of the 110 healthy controls had at least one abnormal procoagulant value. The level of serum estradiol was high in five patients who had received testosterone therapy. ‒ by Monica Jaramillo
Disclosures: The study was supported by the Lipoprotein Research Fund, Jewish Hospital of Cincinnati.
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