The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit–risk assessment of finasteride and dutasteride

@article{Gupta2014TheEA,
  title={The efficacy and safety of 5$\alpha$-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit–risk assessment of finasteride and dutasteride},
  author={Aditya K. Gupta and Andrew Charrette},
  journal={Journal of Dermatological Treatment},
  year={2014},
  volume={25},
  pages={156 - 161}
}
Introduction: In the light of post-marketing reports of persistent sexual dysfunction with the use of finasteride, analysis of the extent of risk associated with 5α-reductase inhibitor treatment for androgenetic alopecia (AGA) is warranted. This study sought to evaluate the efficacy of 5α-reductase inhibitors using the outcomes hair count, global photographic assessment and patient self-assessment and evaluate the benefits of treatment versus the risk of global sexual dysfunction. Methods: A… 
Adverse Sexual Effects of Treatment with Finasteride or Dutasteride for Male Androgenetic Alopecia: A Systematic Review and Meta-analysis.
TLDR
It is important that physicians are aware of, and assess, the possibility of sexual dysfunction in patients treated with 5α-reductase inhibitors, and aware of the risk of adverse sexual effects due to treatment of androgenetic alopecia in male patients with finasteride.
Effect of 5α-Reductase Inhibitors on Sexual Function: A Meta-Analysis and Systematic Review of Randomized Controlled Trials.
5&agr;-Reductase inhibitors in androgenetic alopecia
TLDR
Sexual side-effects are uncommon and resolve spontaneously in most patients even without discontinuing therapy, and although patients treated with 5&agr;RIs have an increased incidence of sexual adverse events, these events decrease if discontinued or over time with continued therapy.
A New Era of 5α-Reductase Inhibitors for Androgenetic Alopecia
TLDR
It is still controversial whether there is significant difference in clinical efficiency by dutasteride and finasteride, as both drugs have been reported to be efficient for AGA.
The Efficacy and Safety of Finasteride Combined with Topical Minoxidil for Androgenetic Alopecia: A Systematic Review and Meta-analysis
TLDR
In patients with AGA, the combination treatment of finasteride and topical minoxidil has better therapeutic efficacy than and similar safety as monotherapy, however, the best concentration of combination treatment requires further studies with sound methodological quality.
Long‐term safety and efficacy of dutasteride in the treatment of male patients with androgenetic alopecia
TLDR
Hair growth, hair restoration and global appearance of hair improved from baseline during the study, and dutasteride 0.5 mg exhibited long‐term safety, tolerability and efficacy within this study population.
Superiority of dutasteride over finasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia: A randomized controlled open-label, evaluator-blinded study
TLDR
Dutasteride was shown to be more efficacious than finasteride and the side-effect profiles were comparable.
Adverse Event Reporting in Clinical Trials of Finasteride for Androgenic Alopecia: A Meta-analysis.
TLDR
It is concluded that finasteride treatment of androgenic alopecia (AGA) is safe but do not assess quality of safety reporting, and published reports of clinical trials provide insufficient information to establish the safety profile forfinasteride in the treatment of AGA.
Persistent erectile dysfunction in men exposed to the 5α-reductase inhibitors, finasteride, or dutasteride
TLDR
To assess whether longer duration of 5α-RI exposure increases risk of PED, independent of age and other known risk factors, a single-group study design and classification tree analysis (CTA) was used to model PED.
...
...

References

SHOWING 1-10 OF 39 REFERENCES
Efficacy and safety of finasteride therapy for androgenetic alopecia: a systematic review.
TLDR
Moderate-quality evidence suggests that daily use of oral finasteride increases hair count and improves patient and investigator assessment of hair appearance, while increasing the risk of sexual dysfunction.
Finasteride in the treatment of Japanese men with male pattern hair loss.
TLDR
Finasteride 1 mg\day slows hair loss and improves hair growth in Japanese men with male pattern hair loss, and was generally well tolerated.
Long-term (5-year) multinational experience with finasteride 1 mg in the treatment of men with androgenetic alopecia.
  • Medicine
    European journal of dermatology : EJD
  • 2002
TLDR
In men with MPHL, long-term treatment with finasteride 1 mg/day over five years was well tolerated, led to durable improvements in scalp hair growth, and slowed the further progression of hair loss that occurred without treatment.
Efficacy and tolerability of finasteride 1 mg in men aged 41 to 60 years with male pattern hair loss.
TLDR
Finasteride 1 mg improved scalp hair growth in men aged 41 to 60 years with predominantly vertex male pattern hair loss compared with results seen with placebo and was generally well tolerated.
Oral finasteride improved the quality of life of androgenetic alopecia patients
TLDR
Oral finasteride did not alleviate the patients' anxiety nor did its efficacy correlate with the level of reported anxiety, but VAS and DLQI are useful for the evaluation of patients’ QOL because of the high sensitivity of these tests.
The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia.
...
...