Testosterone Update

FACULTY
Culley C. Carson III, MD
Rhodes Distinguished Professor
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina

Martin M. Miner, MD
Director, Men's Health Center
Miriam Hospital
Clinical Associate Professor of Family Medicine and Urology
Warren Alpert Medical School of Brown University
Providence, Rhode Island

INTENDED AUDIENCE
Primary care physicians and other healthcare professionals interested in the diagnosis, management, and treatment of benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS), hypogonadism, and erectile dysfunction (ED).

NEEDS ASSESSMENT
As men's life expectancy increases, there is a critical need to address the burgeoning health concerns associated with an aging population, including cardiovascular disease (CVD) that are an increasing cause of morbidity and mortality. It has been established that ED, BPH/LUTS and low testosterone levels are common with aging and studies have investigated the relationship between these comorbid conditions and risk factors for CVD. Therefore, it is critical to examine the relationship between common men's health conditions and CVD and whether morbidity may be decreased with treatment.

Given the close associations between BPH/LUTS, hypogonadism, and ED, treatment algorithms are needed for the concomitant management of LUTS and hypogonadism as well as associated conditions, such as sexual dysfunction, ED and associated CVD. An effective management strategy would incorporate agents that are efficacious and tolerable, cause minimal adverse effects (AEs), and can be used either as monotherapy or in a combination regimen as appropriate. Physicians should take into account individual health factors, efficacy, tolerability, treatment-related AEs (eg, retrograde ejaculation, diminished libido, and ED), cost, and patient preference. As evidence accumulates, considering how daily phosphodiesterase type 5 (PDE5) inhibitor therapy may improve erectile function, BPH/LUTS and cardiometabolic parameters and how treatment of hypogonadism with testosterone therapy affects LUTS, ED, metabolic syndrome components may open new research avenues and shift the current treatment paradigm.

EDUCATIONAL OBJECTIVES
At the conclusion of this activity, participants should be better able to...

Assess the need to screen all men seeking care for hypogonadism, BPH/LUTS, and ED for related comorbidities
Recognize hypogonadism and ED may be early indicators of metabolic syndrome, which predicts serious endothelial dysfunction and CVD
Examine with patients the AE profile of each therapy when deciding the appropriate management strategy for hypogonadism, BPH/LUTS, or ED and carefully monitor the patients' treatment response
Select therapeutic modalities with minimal AEs, including sexual AEs
Monitor the effects of treatment for BPH/LUTS, hypogonadism, or ED on the prostate and metabolic syndrome components
Judge the advantages of integrating hypogonadism, BPH/LUTS, and ED treatment goals to improve quality of life and optimize health outcomes for all men

ACCREDITATION AND CERTIFICATION
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Dannemiller and CogniMed Inc. Dannemiller is accredited by the ACCME to provide continuing medical education for physicians.

Dannemiller designates this live activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)^™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

There is no charge for this activity. Statements of Credit will be provided by e-mail following activity participation and upon completion and electronic submission of the posttest and evaluation to Dannemiller. A link to the evaluation form is provided upon completion of the activity. If you have any questions about your certificate, please e-mail cme@dannemiller.com.

CONTENT REVIEW STATEMENT
To resolve identified/potential conflicts of interest, the educational content was fully reviewed by a physician member of the Dannemiller Clinical Content Review Committee who have no financial relationships with commercial interests. The resulting certified activity was found to provide educational content that is current, evidence based, and commercially balanced.

DISCLOSURE STATEMENT
It is the policy of Dannemiller to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All faculty participating in sponsored programs are expected to identify and reference off-label product use and disclose any significant relationships with those supporting the activity or any others whose products or services are discussed. The faculty for this activity have disclosed that there will not be discussion about the use of products for non-FDA-approved indications.

In accordance with the Accreditation Council for Continuing Medical Education standards, parallel documents from other accrediting bodies, and Dannemiller policy, the following disclosures have been made:

Dannemiller Staff
Mark T. Nadeau, MD, MBA, FAAFP, Clinical Content Reviewer, has nothing to disclose.
Gordon Ringler, Project Manager, has nothing to disclose.

CogniMed Inc. Staff
Estelle Perera, Senior Director, Scientific Affairs and Program Design has nothing to disclose.
Nancy Vogel, Production Editor, has nothing to disclose.

Faculty
Culley C. Carson III, MD, is a consultant to Abbvie, Auxilium, and Lilly; is on the speakers bureaus of Abbvie, Auxilium, and Lilly; and has received research support from Auxilium.
Martin M. Miner, MD, is a consultant for Abbvie, and has received research support from Forrest Laboratories.

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