Interleukin-1 antagonist boosts testosterone in obese men

 

CHICAGO – An anti-inflammatory treatment targeting interleukin-1 receptors eased symptoms in hypogonadal men with obesity and metabolic syndrome,according to a study presented at the annual meeting of the Endocrine Society.

The treatment helps patients by targeting testosterone deficiency associated with metabolic syndrome as well as inflammation associated with hypogonadism.

“Antagonism of the interleukin inflammatory pathway led to improved endogenous testosterone production,” said presenter Fahim Ebrahimi, MD, of the University Hospital Basel, Switzerland. “Even with a clinical period so short, only 4 weeks, we have seen reduced blood pressure and increased grip strength.”

A total of 70 men with metabolic syndrome and hypergonadism from the University Hospital in Basel and Kantonsspital Aarau, Switzerland, were included in the randomized, double-blind, placebo-controlled study.

 

Patients were mostly white, 54-year-old men with an average body mass index of 37 kg/m².

Testosterone levels at baseline were an average of 9.6 nmol/L in the placebo group and 9.1 nmol/L in the test group.

Dr. Ebrahimi and his colleagues randomly assigned patients to either the IL-1 antagonist treatment anakinra, or a placebo for 4 weeks.

Total testosterone levels in the treatment group rose 11% over 4 weeks, ending the trial with an average level 0.96 nmol/L higher than the placebo group, according to the investigators.

Evidence of the positive effects of the anti-inflammatory were clear when patients were broken into subgroups based on baseline inflammation levels.

Patients who did not have baseline inflammation did not respond to treatment, while patients with a baseline CRP level higher than 2 mg/l had an increase of 2.14 nmol/L, explained Dr. Ebrahimi.

 

Treatment response also increased with increased body mass index, with patients who had a BMI above 40 kg/m² seeing testosterone levels improve by 2.64 nmol/L.

Along with higher testosterone, patients in the test group experienced improved grip strength and blood pressure.

Investigators chose targeting IL-1 receptor antagonist specifically because of previous successes with other conditions.

“We chose IL-1 because it has shown previous, very beneficial effects on glucose metabolism, with reductions of A_1c, and is well tolerated,” Dr. Ebrahimi said in response to a question from the audience.

Dr. Ebrahimi and fellow investigators believe this study will help open the door on unanswered questions related to the cardiovascular safety of this kind of treatment.

 

“These data will have a clinical impact, especially against the background of the recently published data from the large randomized trial, which has shown that IL-1 antagonism in these patients lead to a significant reduction in cardiovascular mortality,” Dr. Ebrahimi said. “We also still do not know if this treatment is possibly harmful to the patient on cardiovascular outcomes.”

The investigators reported no relevant financial disclosures.

ezimmerman@frontlinemedcom.com

SOURCE: Ebrahimi F. et al. ENDO 2018, Abstract OR15-6.

 

CHICAGO – An anti-inflammatory treatment targeting interleukin-1 receptors eased symptoms in hypogonadal men with obesity and metabolic syndrome,according to a study presented at the annual meeting of the Endocrine Society.

The treatment helps patients by targeting testosterone deficiency associated with metabolic syndrome as well as inflammation associated with hypogonadism.

“Antagonism of the interleukin inflammatory pathway led to improved endogenous testosterone production,” said presenter Fahim Ebrahimi, MD, of the University Hospital Basel, Switzerland. “Even with a clinical period so short, only 4 weeks, we have seen reduced blood pressure and increased grip strength.”

A total of 70 men with metabolic syndrome and hypergonadism from the University Hospital in Basel and Kantonsspital Aarau, Switzerland, were included in the randomized, double-blind, placebo-controlled study.

 

Patients were mostly white, 54-year-old men with an average body mass index of 37 kg/m².

Testosterone levels at baseline were an average of 9.6 nmol/L in the placebo group and 9.1 nmol/L in the test group.

Dr. Ebrahimi and his colleagues randomly assigned patients to either the IL-1 antagonist treatment anakinra, or a placebo for 4 weeks.

Total testosterone levels in the treatment group rose 11% over 4 weeks, ending the trial with an average level 0.96 nmol/L higher than the placebo group, according to the investigators.

Evidence of the positive effects of the anti-inflammatory were clear when patients were broken into subgroups based on baseline inflammation levels.

Patients who did not have baseline inflammation did not respond to treatment, while patients with a baseline CRP level higher than 2 mg/l had an increase of 2.14 nmol/L, explained Dr. Ebrahimi.

 

Treatment response also increased with increased body mass index, with patients who had a BMI above 40 kg/m² seeing testosterone levels improve by 2.64 nmol/L.

Along with higher testosterone, patients in the test group experienced improved grip strength and blood pressure.

Investigators chose targeting IL-1 receptor antagonist specifically because of previous successes with other conditions.

“We chose IL-1 because it has shown previous, very beneficial effects on glucose metabolism, with reductions of A_1c, and is well tolerated,” Dr. Ebrahimi said in response to a question from the audience.

Dr. Ebrahimi and fellow investigators believe this study will help open the door on unanswered questions related to the cardiovascular safety of this kind of treatment.

 

“These data will have a clinical impact, especially against the background of the recently published data from the large randomized trial, which has shown that IL-1 antagonism in these patients lead to a significant reduction in cardiovascular mortality,” Dr. Ebrahimi said. “We also still do not know if this treatment is possibly harmful to the patient on cardiovascular outcomes.”

The investigators reported no relevant financial disclosures.

ezimmerman@frontlinemedcom.com

SOURCE: Ebrahimi F. et al. ENDO 2018, Abstract OR15-6.

 

CHICAGO – An anti-inflammatory treatment targeting interleukin-1 receptors eased symptoms in hypogonadal men with obesity and metabolic syndrome,according to a study presented at the annual meeting of the Endocrine Society.

The treatment helps patients by targeting testosterone deficiency associated with metabolic syndrome as well as inflammation associated with hypogonadism.

“Antagonism of the interleukin inflammatory pathway led to improved endogenous testosterone production,” said presenter Fahim Ebrahimi, MD, of the University Hospital Basel, Switzerland. “Even with a clinical period so short, only 4 weeks, we have seen reduced blood pressure and increased grip strength.”

A total of 70 men with metabolic syndrome and hypergonadism from the University Hospital in Basel and Kantonsspital Aarau, Switzerland, were included in the randomized, double-blind, placebo-controlled study.

 

Patients were mostly white, 54-year-old men with an average body mass index of 37 kg/m².

Testosterone levels at baseline were an average of 9.6 nmol/L in the placebo group and 9.1 nmol/L in the test group.

Dr. Ebrahimi and his colleagues randomly assigned patients to either the IL-1 antagonist treatment anakinra, or a placebo for 4 weeks.

Total testosterone levels in the treatment group rose 11% over 4 weeks, ending the trial with an average level 0.96 nmol/L higher than the placebo group, according to the investigators.

Evidence of the positive effects of the anti-inflammatory were clear when patients were broken into subgroups based on baseline inflammation levels.

Patients who did not have baseline inflammation did not respond to treatment, while patients with a baseline CRP level higher than 2 mg/l had an increase of 2.14 nmol/L, explained Dr. Ebrahimi.

 

Treatment response also increased with increased body mass index, with patients who had a BMI above 40 kg/m² seeing testosterone levels improve by 2.64 nmol/L.

Along with higher testosterone, patients in the test group experienced improved grip strength and blood pressure.

Investigators chose targeting IL-1 receptor antagonist specifically because of previous successes with other conditions.

“We chose IL-1 because it has shown previous, very beneficial effects on glucose metabolism, with reductions of A_1c, and is well tolerated,” Dr. Ebrahimi said in response to a question from the audience.

Dr. Ebrahimi and fellow investigators believe this study will help open the door on unanswered questions related to the cardiovascular safety of this kind of treatment.

 

“These data will have a clinical impact, especially against the background of the recently published data from the large randomized trial, which has shown that IL-1 antagonism in these patients lead to a significant reduction in cardiovascular mortality,” Dr. Ebrahimi said. “We also still do not know if this treatment is possibly harmful to the patient on cardiovascular outcomes.”

The investigators reported no relevant financial disclosures.

ezimmerman@frontlinemedcom.com

SOURCE: Ebrahimi F. et al. ENDO 2018, Abstract OR15-6.