Endocrine Abstracts

Aim: In normal men testosterone levels fall with age. We wished to assess the efficacy and safety of Nebido in men over the age of 60 years in order to assess dose frequency and other potential complications.

Subjects and methods: Ten men over 60 years of age (range 60–77 median 64) with primary or secondary hypogonadism were treated with Nebido 1000 mg i.m. Each was given a loading dose of two injections 6 weeks apart (our normal protocol for all patients regardless of age). Third and fourth injections were titrated with the aim of a through testosterone level in the lower third of the normal range (range 8.7–28.4 nmol/l). Regular measurements of through testosterone, PSA and FBC were taken.

Results: Baseline mean serum testosterone was 8.2 nmol/l (range 1.5–12.1).

One out of ten patients had an elevated through testosterone pre-2nd injection (24.2 nmol/l) and had next injection interval extended to 24 weeks.

Three out of ten patients had elevated through testosterone levels pre-3rd injection (23.9, 16.1, 17.5) and had next injection interval extended to 16, 15 and 14 weeks respectively.

Two out of ten patients stopped Nebido due to intervals extending >24 weeks.

Three out of ten patients developed polycythaemia, two requiring venesection. Two of these correlated with high through testosterone levels.

There was no significant rise in PSA.

Conclusion: Men over 60 years of age frequently (40%) require extended intervals of >12 weeks between administrations of Nebido. The percentage of patients over 60 years of age who developed polycythaemia was 30%. This highlights the importance of monitoring through testosterone levels prior to administration of Nebido, particularly in patients over 60 years of age.