130 Toremifene Citrate Improves High-Density Lipoprotein Levels in Men on Testosterone Replacement Therapy

Abstract

Decreases in high-density lipoprotein (HDL) levels have been observed in men on testosterone therapy (TTh). Niacin is commonly used as a therapy for low HDL, although its side effect (SE) profile often leads to frequent discontinuation. Toremifine citrate is an oral selective estrogen modulator (SERM) that is well tolerated and can improve lipid profiles by raising HDL levels in both breast and prostate cancer patients. Here we assess the role of toremifene in the management of HDL abnormalities in men on TRT. Determine the effect of torimifene citrate on the HDL levels of hypogonadal men on TTh compared to both niacin and control groups. Men on TTh with low HDL levels (<39 mg/dL) at a single andrology clinic treated between October 2015 and August 2017 treated with either toremifine (60 mg daily), niacin (titrated to 1,000 mg daily over 2 months) plus krill oil (1,000 mg daily) (NKO), or no treatment (patient refusal) were reviewed in a retrospective intent-to-treat analysis. Patient age, type of TTh, length of follow-up, and baseline and subsequent non-fasting lipid panels, total testosterone (TT) levels, and estrogen (E) levels were determined. Analysis of variance (ANOVA) was used to determine differences between groups.