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Phase 4 N=673 Randomized Treatment

A Study of the Effect of Testosterone Replacement Therapy on Blood Pressure in Adult Male Participants With Hypogonadism

Hypogonadism · Hypogonadism, Male · Hypogonadotropic Hypogonadism

Enrolled (actual)
673
Serious AEs
0.9%
Results posted
Mar 2025
Primary outcome: Primary: Change From Baseline in 24-Hour Average Systolic Ambulatory Blood Pressure to End of Study (EOS) — 2.77; 2.78; 2.15 millimeters of mercury (mmHg)

Study Design & Population

Study type
Interventional
Phase
Phase 4
Interventions
Aveed Injectable Product (Drug); Fortesta (Drug); Testim (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
Male
Sponsor
Endo Pharmaceuticals
Primary completion
Jul 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Change From Baseline in 24-Hour Average Systolic Ambulatory Blood Pressure to End of Study (EOS)
2.77; 2.78; 2.15
SECONDARY
Change From Baseline in 24-Hour Average Mean Arterial Pressure (MAP) to EOS
2.13; 1.78; 1.21
SECONDARY
Change From Baseline in 24-Hour Average Diastolic Ambulatory Blood Pressure to EOS
1.85; 1.22; 0.81
SECONDARY
Change From Baseline in 24-Hour Average Heart Rate to EOS
2.89; 1.56; 1.84
SECONDARY
Change From Baseline in 24-Hour Average Pulse Pressure (PP) to EOS
0.80; 1.49; 1.40
SECONDARY
Percentage of Participants Taking New Antihypertensive Medications
1.4; 1.5; 2.2
SECONDARY
Percentage of Participants With Dose Increase From Baseline in Antihypertensive Medications
0; 0; 0

Summary

Testosterone is the principal androgen produced by the male testes. Male Hypogonadism is the result of inadequate production of testosterone by the Leydig cells of the testes and is reflected by total serum concentrations of testosterone of < 300 nanograms (ng)/deciliters (dL), with no discernible diurnal pattern. The etiology of hypogonadism may be primary or secondary. The treatment of males with primary, and in some cases, secondary hypogonadism includes administration of testosterone. Testim® and Fortesta® are topical gels that when applied daily help to increase the total testosterone levels in the blood through skin absorption. Aveed® is an injectable form of testosterone treatment and participants randomized to this treatment arm will receive 3 injections over the course of 16 weeks. This study is designed to evaluate the effect on blood pressure of approved testosterone products (Testim®, Fortesta®, and Aveed®) after 16 weeks of therapy using 24-hour ambulatory blood pressure to reveal shifts in blood pressure levels.

Eligibility Criteria

Inclusion Criteria

  • Have a diagnosis of primary hypogonadism or hypogonadotropic hypogonadism.
  • Have a total serum testosterone at screening < 300 ng/dL based on 2 blood samples obtained at 10 am (+/-2 hours) on 2 separate occasions at least 48 hours apart
  • Be naïve to androgen replacement or washout of 12 weeks following intramuscular androgen injections; 4 weeks following topical or buccal, nasal, or oral androgens.
  • Have a screening blood pressure at rest of less than 140 millimeters of mercury (mm Hg) for systolic blood pressure and less than 90 mm Hg for diastolic blood pressure.
  • Be judged to be in good health.
  • Participants enrolled in the Testim or Fortesta treatment arms: participants agree to take necessary precautions to avoid skin-to-skin contact and potential transfer and if male use effective contraception.
  • Be willing and able to cooperate with the requirements of the study.

Exclusion Criteria

  • Is from a vulnerable population, as defined by the US Code of Federal Regulations (CFR) Title 45, Part 46, Section 46.111(b) and other local and national regulations, including but not limited to, employees (temporary, part-time, full time, etc) or a family member of the research staff conducting the study, or of the sponsor, or of the contract research organization, or of the Institutional Review Board/Independent Ethics Committee (IRB/IEC).
  • Has a history of significant sensitivity or allergy to the study drugs, including androgens, or product excipients.
  • Has a history of or medical examination findings renal, hepatic, neurologic, hematologic, endocrine, oncologic, pulmonary, immunologic, psychiatric conditions, cardiovascular disease/dysrhythmia) or any other condition(s) that restricts study participation.
  • Has clinically significant changes in any medications (including dosages) or medical conditions in the 28 days prior to screening
  • Is not on a stable medication regimen for at least 3 months for the treatment of a chronic condition.
  • Has had a cardiovascular and/or cerebrovascular event within the last 6 months.
  • Needs blood pressure cuff size larger than 50 centimeters.
  • Works a night shift or performs heavy manual labor.
  • Has any known contraindication(s) to active study treatment including, but not limited to: known or suspected carcinoma of the prostate or breast, previous history of cancer (except basal cell carcinoma of the skin) liver disease, active deep vein thrombosis, atrial fibrillation, untreated sleep apnea, or is immune compromised.
  • Uses known inhibitors (for example, ketoconazole) or inducers of cytochrome P450 3A (for example, dexamethasone, phenytoin, rifampin, carbamazepine) of cytochrome P450 3A (CYP3A) within 30 days prior to study drug administration and through the end of the study.
  • Uses any of the above listed drugs within 5 half lives of the last dose in the past 6 months prior to study drug administration.
  • Has received any of the above listed drugs by injection within 30 days or 10 half lives (whichever is longer) prior to study drug administration.
  • Uses nutraceuticals or homeopathic compounds which have a known effect on blood pressure.
  • Has a history of drug or alcohol abuse within 6 months prior to study drug administration.
  • Has untreated moderate to severe depression.
  • Has any skin lesions/cuts/injury at the application site that prohibits topical application and/or intramuscular injection of study drug.
  • Has suspected reversible hypogonadism.
  • Donated blood or blood products or experienced significant blood loss within 90 days prior to study drug administration.
  • Intends to conceive at any time during the study.
  • Donated bone marrow within 6 months prior to study drug administration.
  • Has participated in a previous investigational study or received treatment with an investigational product within 30 days of screening.
  • Has a diagnosis of, is undergoing therapy for, or has received therapy for a hematologic
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04456296). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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