Endocrine Abstracts

Introduction: Low testosterone levels are found in up to 50% of male patients with chronic obstructive pulmonary disease (COPD), and acute illness is associated with further suppression of the central and peripheral gonadal axis. Testosterone supplementation in chronic stable COPD patients has yielded mixed results, demonstrating increased lean body mass, and improved exercise capacity in some studies, but not others. Use of anabolic steroids during acute illness has shown benefits in selected populations, particularly major burns patients. We studied the use of testosterone augmentation in patients with acute exacerbation of COPD, in improving functional exercise capacity and recovery during their hospitalisation.

Methods: We conducted a randomised, placebo-controlled trial in 60 consecutive patients admitted with the primary diagnosis of acute exacerbation of COPD. Patients with a secondary diagnosis of other concomitant acute illness such as myocardial infarction, or acute renal failure were excluded. At baseline, blood tests (FSH, LH, Testosterone, SHBG, Albumin, Full blood count), anthropometric measurements, BORG dyspnea scale and 6 min walk tests (6MWT) were conducted. Patients were then randomised to receive either testosterone cypionate (400 mg i.m.) or placebo on 1st day of admission. BORG dyspnea scale and 6MWT were repeated during the hospitalisation and 2 weeks after discharge. Outcome measures included duration of hospitalisation, BORG dyspnea scale and 6MWT results. Patients will be stratified by their baseline testosterone levels.

Results: Recruitment of subjects is currently still ongoing. Currently, 10 patients have been recruited. Preliminary data analysis of the subjects (age range 62–78 years) show a trend towards a shorter hospitalisation stay, and improved dyspnea scale and 6MWT results.

Conclusion: Testosterone supplementation may offer a novel therapy to improve recovery from acute illness, particularly in patients with COPD who often have a low baseline testosterone level.