Clin Gastroenterol Hepatol

Testosterone therapy improves outcomes in cirrhosis patients

May 12, 2025

Study details: This emulated clinical trial evaluated the impact of testosterone replacement therapy among men diagnosed with hypogonadism at the same time as cirrhosis. Using nationally representative Medicare data from 2008-2020, researchers examined the risk of death, decompensation events, and fractures in patients who did or didn't receive testosterone. The study balanced treated and untreated groups with inverse probability of treatment weighting and used an intention-to-treat design.

Results: Out of 282 patients with testicular hypofunction and cirrhosis, those who received testosterone replacement therapy spent significantly more patient-days on therapy compared with those who didn't (28.6% vs. 0.5%, P < 0.0001). Testosterone use was associated with lower mortality (subdistribution hazard ratio [sHR], 0.92; 95% confidence interval [CI], 0.85-0.99) and reduced risk of new decompensation events (sHR, 0.92; 95% CI, 0.86-0.99), particularly ascites requiring paracentesis (sHR, 0.82; 95% CI, 0.76-0.89) and variceal hemorrhage (sHR, 0.67; 95% CI, 0.54-0.85).

Clinical impact: Testosterone replacement therapy can improve clinical outcomes for older patients with cirrhosis and hypogonadism, potentially reducing mortality and the risk of severe complications. This could inform future treatment protocols and enhance patient care.

Source:

Tapper EB, et al. (2025, March 15). Clin Gastroenterol Hepatol. Testosterone Replacement Reduces Morbidity and Mortality for Most Patients With Cirrhosis. https://pubmed.ncbi.nlm.nih.gov/40097035/