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

Abstract

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 systematic review identified all relevant randomized controlled trials of finasteride 1 mg, 5 mg and dutasteride 0.5 mg. The efficacy outcome hair count was analyzed using pair-wise meta-analysis, while the efficacy outcomes global photographic assessment and patient self-assessment as well as the safety outcome global sexual dysfunction were analyzed through network meta-analyses. A benefit-risk assessment was also performed.

RESULTS:

The active interventions were not significantly different than each other in efficacy and were not significantly different from placebo in eliciting sexual dysfunction. Benefit-risk analysis resulted in an arbitrary ranking due to the lack of statistically significant difference between active treatments.

DISCUSSION:

Analysis results reiterate the efficacy and safety of 5α-reductase inhibitors for the treatment of AGA and may support the approval of dutasteride 0.5 mg as an additional treatment option, following further study.

• Authors: Aditya K Gupta, Andrew Charrette
• Journal: The Journal of dermatological treatment (J Dermatolog Treat) Vol. 25 Issue 2 Pg. 156-61 (Apr 2014) ISSN: 1471-1753 [Electronic] England
• PMID: 23768246 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)

Chemical References

• 5-alpha Reductase Inhibitors
• Azasteroids
• Finasteride
• Dutasteride

Topics

• 5-alpha Reductase Inhibitors (therapeutic use)
• Alopecia (drug therapy)
• Azasteroids (therapeutic use)
• Dutasteride
• Finasteride (therapeutic use)
• Humans
• Male
• Photography
• Randomized Controlled Trials as Topic
• Risk Assessment
• Self Report