Group calls for investigation of JAMA over T study

The Androgen Study Group has called upon the Journal Oversight Committee to investigate what it deemed violations of “accepted standards of medical journal ethics and editorial integrity” by JAMA.

The ASG’s complaint was in regard to a controversial JAMA study that reported increased cardiovascular risks in men receiving testosterone prescriptions compared with untreated men (2013; 310:1829-30). That study and another in PLoS One (2014; 9:e85805) prompted the FDA to investigate the safety of testosterone products, and the advocacy group Public Citizen to petition the FDA for a black box warning on testosterone-containing products. (The petition was subsequently rejected.)

Following the publication of the studies, the ASG was formed “to ensure that the results of research regarding testosterone deficiency and its treatment is presented accurately and fairly within medical literature and to the public,” according to the group’s website. Its members include Abraham Morgentaler, MD, Abdulmaged Traish, PhD, MBA, Martin Miner, MD, Mohit Khera, MD, MBA, MPH, and Andre Guay, MD.

The ASG had previously called for JAMA to retract the article. Although the study has since undergone two formal corrections, “JAMA and the study authors have stood by their findings,” the ASG said in a press release.

“One week after its initial publication, JAMA replaced online the original study with a revised version. Yet JAMA failed to disclose for 2 months that this highly read article had already undergone a major correction,” the ASG said. The group called this delay an “active form of deception” that represented a “major breach of editorial ethics.”

“This article is a mess, and JAMA has behaved badly. Something is terribly amiss when a premier medical journal publishes such an obviously weak study that contradicts well-established literature, and in so doing, fosters fear among the public. The concern is heightened when the journal’s response to inescapable evidence that the study is meritless is to deceive, distort, stonewall, and dig in,” the ASG said.

For more on the Androgen Study Group and the ongoing testosterone controversy, check out this feature from our August issue, written by Dr. Morgentaler.

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In related news, a recent study has found that men, women, and children exposed to high levels of phthalates tended to have reduce levels of testosterone in their blood compared to those with less exposure to the chemicals.

For the study, which was published online in the Journal of Clinical Endocrinology & Metabolism (Aug. 14, 2014), the authors examined phthalate exposure and testosterone levels in 2,208 people. They reported an inverse relationship between phthalate exposure and testosterone levels at various life stages.

“We found evidence reduced levels of circulating testosterone were associated with increased phthalate exposure in several key populations, including boys ages 6-12, and men and women ages 40-60. This may have important public health implications, since low testosterone levels in young boys can negatively impact reproductive development, and in middle age can impair sexual function, libido, energy, cognitive function, and bone health in men and women,” said co-author John D. Meeker, MS, ScD, of the University of Michigan School of Public Health in Ann Arbor.

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