5‐Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety

Dhurat, Rachita; Sharma, Aseem; Rudnicka, Lidia; Kroumpouzos, George; Kassir, Martin; Galadari, Hassan; Wollina, Uwe; Lotti, Torello; Golubović, Maša; Binić, Iva; Grabbe, Stephan; Goldust, Mohamad

doi:10.1111/dth.13379

Cited by 42 publications

(43 citation statements)

References 39 publications

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“…Dutasteride, a dual receptor DHT blocker, has a higher potency than its predecessor, finasteride. 2020 Dhurat et al [ 72 ] Finasteride treatment can augment estradiol levels and also block posttraumatic cytokine secretion of alveolar macrophages (AM), as well as decrease concentration of MCP-1 and MIP-1β in lung tissue. 2011 Zeckey et al [ 59 ] Finasteride administration prevents the increase in cytokine plasma levels, decreases DHT, and increases 17beta-estradiol plasma concentrations.…”

Section: Methodsmentioning

confidence: 99%

Is COVID-19 a risk factor for progression of benign prostatic hyperplasia and exacerbation of its related symptoms?: a systematic review

Haghpanah

Masjedi

Salehipour

et al. 2021

Prostate Cancer Prostatic Dis

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Background To explore the potential mechanisms of SARS-CoV-2 in targeting the prostate gland, leading to exacerbation of benign prostatic hyperplasia (BPH) symptoms and greater risks of BPH complications such as acute urinary retention. Methods A categorized and comprehensive search in the literature has been conducted by 10 April 2021 using international databases including PubMed, Embase, Web of Science, Scopus, and Cochrane Library in line with the PRISMA guidelines recommendations. PICO strategy was used to formulate the research question. The following terms were used: urology, COVID-19, coronavirus, BPH, inflammation, androgen receptors, LUTS, IPSS, PSA, and SARS-CoV-2 or a combination of them. Studies with irrelevant purposes and duplicates were excluded. The selected studies were performed on humans and published in English. Results The research revealed 89 articles. After title screening and considering exclusion criteria, 52 papers were included for the systematic review. BPH is a common condition affecting older men. SARS-CoV-2 infects the host cell by binding to angiotensin converting enzyme 2 (ACE2). A hyperactivated RAS system during infection with SARS-CoV-2 may lead to activation of pro-inflammatory pathways and increased cytokine release. Thus, this virus can lead to exacerbation of lower urinary tract symptoms (LUTS) and trigger inflammatory processes in the prostate gland. Since androgen receptors (AR) play an important role in the BPH pathophysiology and infection with SARS-CoV-2 may be androgen-mediated, BPH progression and its related symptoms can be a complication of COVID-19 through AR involvement and metabolic disturbances. Conclusions Based on the current findings, SARS-CoV-2 can possibly damage the prostate and worsen BPH and its related LUTS through ACE2 signaling, AR-related mechanisms, inflammation, and metabolic derangement. We encourage future studies to investigate the possible role of COVID-19 in the progression of BPH-related LUTS and examine the prostatic status in susceptible patients with relevant available questionnaires (e.g., IPSS) and serum biomarkers (e.g., PSA).

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Section: Methodsmentioning

confidence: 99%

Is COVID-19 a risk factor for progression of benign prostatic hyperplasia and exacerbation of its related symptoms?: a systematic review

Haghpanah

Masjedi

Salehipour

et al. 2021

Prostate Cancer Prostatic Dis

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“…The characteristic pathology is a progressive miniaturization of the hair follicle that leads to formation of thin, short (vellus) hair. Currently, the only treatments approved by the United States Food and Drug Administration (US FDA) for AGA are topical minoxidil solution and oral finasteride, 23 while oral dutasteride is approved in South Korea and Japan 24 . Other options include oral bicalutamide, 25 oral spironolactone, intralesional injections with platelet rich plasma (PRP), and hair transplant 23 …”

Section: Photobiomodulation As Hair Loss Treatmentmentioning

confidence: 99%

Photobiomodulation for the management of hair loss

Torres

Lim

2021

Photoderm Photoimm Photomed

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Photobiomodulation, otherwise known as low‐level laser (or light) therapy, is an emerging modality for the management of hair loss. Several randomized trials have demonstrated that it is safe and potentially effective on its own or in combination with standard therapies. These devices come in many forms including wearable caps or helmets that afford hands‐free and discreet use. Models with light‐emitting diodes (LEDs) are less expensive compared to laser‐based devices and do not require laser safety considerations, thus facilitating ease of home use. Limitations include cost of the unit, risk of information bias, and lack of standardized protocols. Finally, as with any hair loss treatment, patients' expectations with regards to therapeutic outcomes must be managed.

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“…ARIs have been shown to reduce AR activity in many tissues. 1,4 However, caution should be exercised when attempting to draw conclusions about the safety of medications such as 5-ARIs that have variable effects on multiple tissues. Finasteride and less selective dutasteride block 5-AR isoform 3, which is expressed in the respiratory epithelium and fibroblasts.…”

Section: -mentioning

confidence: 99%

“…Finasteride is approved by the US Food and Drug Administration for androgenetic alopecia and benign prostate hypertrophy, and dutasteride for androgenetic alopecia in South Korea and Japan. 4…”

mentioning

confidence: 99%

Effects of 5‐alpha reductase inhibitors on lung function: A reason for discontinuation duringCOVID‐19 pandemic?

Kroumpouzos

2020

Dermatologic Therapy

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5‐Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety

Cited by 42 publications

References 39 publications

Is COVID-19 a risk factor for progression of benign prostatic hyperplasia and exacerbation of its related symptoms?: a systematic review

Is COVID-19 a risk factor for progression of benign prostatic hyperplasia and exacerbation of its related symptoms?: a systematic review

Photobiomodulation for the management of hair loss

Effects of 5‐alpha reductase inhibitors on lung function: A reason for discontinuation duringCOVID‐19 pandemic?

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