Sexual science milestone
In an accompanying editorial, Peer Briken, MD, of the Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry at University Medical Centre, Hamburg, Germany, wrote that the innovative potential of this study should “not be underestimated.”
It has previously been thought that randomized, controlled trials were not possible because it might be unethical to withhold therapy from high-risk participants and thus risk sexual assaults on children in a control group, Dr. Briken noted.
With the current study, “the situation has changed, which marks a milestone in clinical sexual science and the field of forensic psychiatry,” he wrote.
However, the “great benefit” of the study, which is the proof of feasibility of a randomized, controlled trial in this special group of patients and use of a new drug, comes with some “important limitations,” he added.
Only three participants in each treatment group were in the high-risk subgroup. In addition, the most important long-term outcome criterion – reduction in recidivism in high-risk individuals – could not be investigated, he said.
Dr. Briken agreed with the investigators that risk of suicidal tendencies during rapid testosterone withdrawal requires attention.
Despite its limitations, this study is “certainly the most important contribution to the field of pharmacotherapy of pedophilic disorders since Rösler and Witztum’s study on GnRH agonists in 1998. Also, a relevant number of the study participants (58%) were in favor of further application,” he concluded.
The study was funded by the Swedish Society of Medicine, the Söderström-Königska Foundation, the Fredrik and Ingrid Thuring Foundation, the Centre for Psychiatric Research at Karolinska Institutet, the Gothenburg Society of Medicine, Skaraborg Hospital research unit, Region Stockholm, and the Swedish Society for Medical Research. Dr. Rahm and Dr. Briken have disclosed no relevant financial relationships.
A version of this article originally appeared on Medscape.com.