Anastrozole

In a one-year placebo-controlled trial in older men, anastrozole reduced spine bone mineral density despite increased testosterone. The earlier 12-week absence of a bone effect does not establish long-term bone safety.^[2]

• Older selected male population; spine bone density is not the same outcome as fracture incidence.

A 12-week trial in older mildly hypogonadal men found increased testosterone and reduced estradiol with anastrozole. Its short-term bone results do not establish long-term bone safety; a later one-year trial found reduced spine bone density.^[1][2]

• Short follow-up cannot exclude bone loss with longer exposure; compare the separately inspected one-year trial.
• Abstract-checked; no qualified clinical review.

In breast-cancer patients, tamoxifen coadministration lowered anastrozole plasma concentration by 27%. The combination offered no efficacy advantage over tamoxifen in the ATAC trial; ARIMIDEX labeling advises against their coadministration.^[3]

• Postmenopausal breast-cancer population; no inference of a specific clinical outcome in men using these drugs after androgen exposure.
• Does not generalize to every SERM/aromatase-inhibitor pair.

A controlled study in men linked estrogen deficiency to increased body fat and a contribution to reduced sexual function. It does not establish the outcome of combining aromatase inhibitors or adding one to a particular anabolic steroid.^[4]

• This evidence does not establish the magnitude or frequency of harm from the selected combination.