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Several clinical guidelines and U.S. FDA communications have highlighted concerns about cardiovascular risks associated with testosterone use, especially in men with known cardiovascular disease (CVD). Using Medicare claims data, researchers explored use of “off-label” testosterone (for age-related hypogonadism rather than for diseases with primary testosterone deficiency) in men with or without known CVD. Cohorts of men (age, >50; mean age, 71) were identified annually from 2007 to 2016. About one third of each cohort had known CVD.
On-label testosterone use remained flat during the 10-year study (≈0.2%–0.3% for men with or without CVD). However, prescription rates for off-label use were 1.2% in 2007, 3.2% in 2013 and 2014, and 2.0% in 2016…