Table 3.
Crude and adjusted rate ratios of venous thromboembolism (VTE) stratified by route of administration of testosterone treatment and VTE risk factor status
| No (%) | Rate ratio (95% CI) | |||
|---|---|---|---|---|
| Cases | Controls | Crude | Adjusted* | |
| Route of administration | (n=19 215) | (n=909 530) | ||
| No recent testosterone treatment | 19 124 (99.53) | 907 433 (99.77) | 1 | 1 |
| Current testosterone treatment† | ||||
| Intramuscular | 40 (0.21) | 678 (0.07) | 1.88 (1.34 to 2.64) | 1.24 (0.87 to 1.77) |
| Transdermal | 24 (0.12) | 453 (0.05) | 1.87 (1.21 to 2.87) | 1.31 (0.84 to 2.04) |
| Oral | 5 (0.03) | 97 (0.01) | 1.76 (0.69 to 4.53) | 1.32 (0.49 to 3.55) |
| Implant | 0 | 23 | – | – |
| Without known VTE risk factors | (n=9770) | (n=488 461) | ||
| No testosterone treatment | 9726 (99.55) | 487 270 (99.76) | 1 | 1 |
| Current testosterone treatment† | 37 (0.38) | 784 (0.16) | 2.46 (1.75 to 3.46) | 1.57 (1.06 to 2.32) |
| Started ≤6 months before | 17 (0.17) | 321 (0.07) | 2.75 (1.68 to 4.50) | 1.91 (1.13 to 3.23) |
| Started >6 months before | 20 (0.20) | 463 (0.09) | 2.25 (1.43 to 3.56) | 1.35 (0.82 to 2.24) |
| Recent testosterone use§ | 7 (0.07) | 407 (0.08) | 0.88 (0.42 to 1.86) | 0.62 (0.29 to 1.33) |
| With known VTE risk factors | (n=9445) | (n=421 069) | ||
| No testosterone treatment | 9398 (99.50) | 420 163 (99.78) | 1 | 1 |
| Current testosterone treatment† | 32 (0.34) | 467 (0.11) | 1.36 (0.92 to 2.00) | 0.99 (0.65 to 1.49) |
| Started ≤6 months before | 19 (0.20) | 208 (0.05) | 1.89 (1.13 to 3.15) | 1.41 (0.82 to 2.41) |
| Started >6 months before | 13 (0.14) | 259 (0.06) | 0.96 (0.53 to 1.73) | 0.68 (0.37 to 1.27) |
| Recent testosterone use§ | 15 (0.16) | 439 (0.10) | 0.87 (0.51 to 1.49) | 0.70 (0.39 to 1.23) |
*Adjusted for age, history of primary or secondary hypogonadism, surgical procedures, medical illness, trauma, and active cancer in 90 days before index date and for history of cancer ≥91 days before index date (matching factors); for smoking, body mass index, alcohol, socioeconomic status, any history of polycythaemia, chronic pulmonary disease, diabetes, congestive heart failure, myocardial infarction, peripheral vascular disease and stroke, sexual dysfunction, tiredness, and covariate comprising osteoporosis, infertility, loss of appetite, and hot flushes; and for use of corticosteroids, megestrol, non-steroidal anti-inflammatory drugs, and antiplatelets within 90 days of index date.
†Defined as prescription for which duration included index date.
‡Defined as hospital diagnosis of medical condition or trauma or in-hospital surgical procedure in 90 days before index VTE, or history of cancer recorded any time before index date.
§Defined as use that ended between two years and one day before index date.