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The Testosterone Trial in Older Men

This study is ongoing, but not recruiting participants.
National Institute on Aging (NIA)
National Institute of Neurological Disorders and Stroke (NINDS)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
University of Pennsylvania Identifier:
First received: November 26, 2008
Last updated: November 3, 2015
Last verified: November 2015

The Testosterone Trials are a multi-center set of trials involving 12 clinical sites geographically distributed across the United States.

The primary specific aims are to test the hypotheses that testosterone treatment of elderly men whose serum testosterone concentrations are unequivocally low - and who have symptoms and objectively measured abnormalities in at least one of five areas that could be due to low testosterone (physical or sexual function, vitality, cognition, and anemia) - will result in more favorable changes in those abnormalities than placebo treatment.

Two additional trials have been incorporated into the T Trial. Only men enrolled in the T Trial are eligible to participate in these trials.

  • The Cardiovascular Trial will examine if testosterone treatment results in more favorable changes in cardiovascular risk factors, compared to placebo.
  • The Bone Trial will test the hypothesis that testosterone treatment will increase volumetric trabecular bone mineral density (vBMD) of the lumbar spine as measured by quantitative computed tomography (QCT), compared with placebo treatment.

A Pharmacokinetic (PK) Study is also being conducted within the context of the interventional T Trial. It will examine the variability of the serum testosterone (T) concentration after application of testosterone gel or placebo, four months after the start of treatment.

Condition Intervention Phase
Andropause Drug: AndroGel® (testosterone gel) Drug: Placebo Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Randomized, Placebo-controlled, Double-blind Study of Five Coordinated Testosterone Treatment Trials in Older Men

Resource links provided by NLM:

Further study details as provided by University of Pennsylvania:

Primary Outcome Measures:
  • Each of the 7 trials has its own primary outcome: [ Time Frame: 1 year ]

    PHYSICAL FUNCTION: Increase from baseline of ≥ 50 m in 6 minute walk test. SEXUAL FUNCTION: Change from baseline in responses to Question 4 of the Harbor-UCLA Sexual Function Questionnaire.

    VITALITY: Increase from baseline in score on the FACIT-Fatigue scale by ≥ 4 points.

    COGNITIVE FUNCTION: Change from baseline in responses to the Wechsler Memory Scale Revised (WMS-R) Logical Memory II, in men with AAMI at baseline.

    CARDIOVASCULAR: Change from baseline in non-calcified plaque volume as measured by CT angiography.

    BONE: Percent change from baseline in volumetric bone mineral density of trabecular bone of the spine as measured by quantitative computed tomography (QCT) scan.

    ANEMIA: Increase in hemoglobin by ≥ 1.0 g/dL in men with anemia of unknown cause at baseline.

Secondary Outcome Measures:
  • The 7 trials have secondary outcomes: [ Time Frame: 1 year ]

    PHYSICAL FUNCTION: Improvement of ≥ 8 on PF-10/SF-36; change in 6-minute walk distance; both outcomes combined.

    SEXUAL FUNCTION: Change Harbor UCLA 7-day Sexual Function Questionnaire, DISF-II-M, IIEF.

    VITALITY: Change on the Vitality Scale/SF-36, PANAS, PHQ-9. COGNITIVE FUNCTION: Change on BVRT, Card Rotations, Trails A minus the log-transformed total time for Trails B, 3MSE.

    CARDIOVASCULAR: Change measured by CT in log-transformed coronary artery calcium, total plaque volume and subcutaneous fat; change in HgA1C in men not being treated for diabetes; change in HOMA-IR (not limited to those enrolled in cardiovascular trial).

    BONE: Change (QCT) in trabecular vBMD, bone strength, cortical bone strength and whole bone strength of the spine; trabecular bone vBMD and whole bone strength of the hip; areal bone mineral density of the spine (DEXA).

    ANEMIA: Change from baseline in continuous hemoglobin.

Other Outcome Measures:
  • Exploratory Outcomes [ Time Frame: 1 year ]
    A number of exploratory outcomes have been pre-specified.

Estimated Enrollment: 800
Study Start Date: November 2009
Estimated Study Completion Date: June 2016
Primary Completion Date: July 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: AndroGel® (testosterone gel)
AndroGel is applied to the shoulders, abdomen or upper arms once a day. Subjects will be instructed to wash their hands after application and not to have contact with women or children while the gel is wet. They will also be asked not to bathe or get this area wet for five hours after application. The initial dose of AndroGel will be 5.0 g (containing 50 mg of testosterone) once a day.
Drug: AndroGel® (testosterone gel)
Testosterone levels will be measured at regular intervals in order to achieve a testosterone level in the desired range.
Other Name: Testosterone gel
Placebo Comparator: Placebo gel
Placebo gel is identical to the testosterone gel and is supplied in an identical pump bottle container. It is applied to the shoulders, abdomen or upper arms once a day. Subjects will be instructed to follow the same precautions to avoid contact with others.
Drug: Placebo
Testosterone levels will be measured at regular intervals.

Detailed Description:

As men get older, they experience many conditions, often together, that eventually result in the inability to perform many activities of daily living, an increased propensity to fall, and decreased independence. These conditions include mobility disability and low vitality. Elderly men also experience increased anemia, metabolic syndrome, decreased sexual function and memory impairment. These conditions likely have multiple causes, but one cause that could contribute to all of them is a low serum testosterone concentration. When young hypogonadal men are treated with testosterone, they experience improvements in sexual function, muscle mass and strength, bone mineral density, sense of well being, and anemia. However, the benefits of testosterone therapy in older men with age-related decline in testosterone concentration are not known and are the subject of this investigation.

Participants will be treated with testosterone or placebo gel for 1 year. The dose will be adjusted in a blinded fashion to achieve a target T level range. Participants will be followed for one additional year following the treatment phase to assess adverse events.

  • Men participating in the Cardiovascular Trial will be assessed for changes in atherosclerotic plaque burden from 0 to 12 months.
  • Men participating in the Bone Trial will be assessed by QCT of the spine and hip, DXA of the spine and hip and clinical fractures at 0 and 12 months.
  • Men participating in the PK Study will attend 3 additional study visits for blood draws at the time of the 4-month assessment.

Ages Eligible for Study:   65 Years and older   (Adult, Senior)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Men greater than or equal to 65 years old
  • Total serum testosterone concentration < 275 and < 300 ng/dL at 7 -10 AM at each of two screening visits

Exclusion Criteria:

  • Diagnosed prostate cancer, prostatic intraepithelial neoplasia (PIN), prostate nodule or, by the Prostate Cancer Risk Calculator, a >35% risk of having overall prostate cancer or >7% risk of having high grade prostate cancer
  • Severe lower urinary tract symptoms (score of > 19) by the International Prostate Symptom Score questionnaire
  • Hemoglobin <10 g/dL or >16.0 g/dL
  • Sleep apnea, diagnosed but untreated
  • Alcohol or substance abuse within the past year (based on self report)
  • Angina not controlled by treatment
  • NYHA class III or IV congestive heart failure
  • Myocardial infarction within the previous 3 months before entry
  • Stroke within the previous 3 months before entry
  • Severe pulmonary disease that precludes physical function tests
  • Serum creatinine >2.2 mg/dL; ALT 3x upper limit of normal; hemoglobin A1c >8.5%, TSH > 7.5mIU/L
  • Diagnosis or treatment for cancer within the past 3 years, with the exception of nonmelanotic skin cancer
  • Body mass index (BMI) >37 kg/m2
  • Mini Mental State Exam (MMSE) Score <24
  • Major psychiatric disorders, including major depression (PHQ-9 score > 14), mania, hypomania, psychosis, schizophrenia or schizoaffective disorders, that are untreated, unstable, have resulted in hospitalization or medication change within the previous three months, or would result in inability to complete the trial efficacy instruments. Subjects whose disorders have been stable while being treated for more than three months are eligible.
  • Use of the following medications within the previous three months:

    • drugs that affect serum testosterone concentration
    • rhGH or megestrol acetate
    • introduction of anti-depressant medication
    • daily use of prednisone for more than two weeks
  • Opiate use within the past three months
  • Skin conditions at the testosterone gel application site, such as ulcer, erosion, lichenification, inflammation, or crust, or generalized skin conditions such as psoriasis or eczema that might affect testosterone absorption or tolerability of the testosterone gel
  • Known skin intolerance to alcohol or allergy to any of the ingredients of testosterone gel

Participants in the T Trial may also enroll in the Cardiovascular and Bone Trials if it is determined that they are eligible based on the specific exclusion criteria.

Participation in the PK Study does not involve additional exclusion criteria.

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00799617

United States, Alabama
University of Alabama at Birmingham
Birmingham, Alabama, United States, 35294
United States, California
University of California San Diego
La Jolla, California, United States, 92093
Center for Men's Health LA BioMed at Harbor-UCLA Medical Center
Torrance, California, United States, 90501
United States, Connecticut
Yale University
New Haven, Connecticut, United States, 06520
United States, Florida
University of Florida
Gainesville, Florida, United States, 32611
United States, Illinois
Northwestern University
Chicago, Illinois, United States, 60208
United States, Massachusetts
Boston University
Boston, Massachusetts, United States, 02215
United States, Minnesota
University of Minnesota
Minneapolis, Minnesota, United States, 55455
United States, New York
Albert Einstein College of Medicine
Bronx, New York, United States, 10461
United States, Pennsylvania
University of Pittsburgh
Pittsburgh, Pennsylvania, United States, 15261
United States, Texas
Baylor College of Medicine
Houston, Texas, United States, 76798
United States, Washington
VA Puget Sound Health Care System
Seattle, Washington, United States, 98108
Sponsors and Collaborators
University of Pennsylvania
National Institute on Aging (NIA)
National Institute of Neurological Disorders and Stroke (NINDS)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Heart, Lung, and Blood Institute (NHLBI)
Principal Investigator: Peter J Snyder, MD University of Pennsylvania
  More Information

Additional Information:
Publications automatically indexed to this study by Identifier (NCT Number):

Responsible Party: University of Pennsylvania Identifier: NCT00799617     History of Changes
Other Study ID Numbers: U01AG030644 ( U.S. NIH Grant/Contract )
R01AG037679 ( U.S. NIH Grant/Contract )
Study First Received: November 26, 2008
Last Updated: November 3, 2015

Keywords provided by University of Pennsylvania:
Mobility disability
Decreased libido
Age associated memory impairment
Low vitality

Additional relevant MeSH terms:
Testosterone enanthate
Testosterone undecanoate
Testosterone 17 beta-cypionate
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Anabolic Agents processed this record on August 18, 2017