Drug Treatment for Androgenetic Alopecia: First Italian Questionnaire Survey on What Dermatologists Think about Finasteride

Sorbellini, Elisabetta; Pinto, Daniela; Mora, Barbara; Rinaldi, Fabio

doi:10.1007/s13555-018-0233-6

Cited by 10 publications

(7 citation statements)

References 41 publications

(32 reference statements)

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“…Table 3 summarizes the findings from systematic reviews and meta-analyses and pharmacovigilance studies and general reviews (60,83,85,86,102,(161)(162)(163)(164)(165)(166)(167)(168)(169)(170)(171)(172)(173)(174)(175)(176). While some of these studies attempted to dismiss the mere existence of persistent sexual and psychiatric adverse events, the overwhelming conclusions of majority of these studies acknowledged the evidence for the persistent sexual and neurological adverse side effects and highlighted the need for better understanding of this syndrome in order to offer treatment for afflicted individuals.…”

Section: Clinical Studies Reporting Sexual Adverse Side Effectsmentioning

confidence: 99%

Post-finasteride syndrome: a surmountable challenge for clinicians

Traish

2020

Fertility and Sterility

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Post-finasteride syndrome (PFS) is a constellation of serious adverse side effects manifested in clinical symptoms that develop and persist in patients during and/or after discontinuing finasteride treatment in men with pattern hair loss (androgenetic alopecia) or benign prostatic hyperplasia. These serious adverse side effects include persistent or irreversible sexual, neurological, physical and mental side effects. To date, there are no evidence-based effective treatments for PFS. Although increasing number of men report persistent side effects, the medical community has yet to recognize this syndrome nor are there any specific measures to address this serious and debilitating symptoms. Here we evaluate the scientific and clinical evidence in the contemporary medical literature to address the very fundamental question: Is PFS a real clinical condition caused by finasteride use or are the reported symptoms only incidentally associated with but not caused by finasteride use? One key indisputable clinical evidence noted in all reported studies with finasteride and dutasteride was that use of these drugs is associated with development of sexual dysfunction, which may persist in a subset of men, irrespective of age, drug dose or duration of study. Also, increased depression, anxiety and suicidal ideation in a subset of men treated with these drugs were commonly reported in a number of studies. It is important to note that many clinical studies suffer from incomplete or inadequate assessment of adverse events and often limited or inaccurate data reporting regarding harm. Based on the existing body of evidence in the contemporary clinical literature, the author believes that finasteride and dutasteride induce a constellation of persistent sexual, neurological and physical adverse side effects, in a subset of men. These constellations of symptoms constitute the basis for PFS in individuals predisposed to epigenetic susceptibility. Indeed, delineating the pathophysiological mechanisms underlying PFS will be of paramount importance to the understanding of this syndrome and to development of potential novel therapeutic modalities. (Fertil Steril Ò 2020;113:21-50. Ó2019 by American Society for Reproductive Medicine.

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Section: Clinical Studies Reporting Sexual Adverse Side Effectsmentioning

confidence: 99%

Post-finasteride syndrome: a surmountable challenge for clinicians

Traish

2020

Fertility and Sterility

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“…The most common side effects are on sexual sphere: loss of libido, erectile dysfunction, and problems with ejaculation, 12‐13 but they are rare and usually disappear with the withdrawal of the drug.…”

Section: Non‐cicatricial Hair Diseasesmentioning

confidence: 99%

Common causes of hair loss – clinical manifestations, trichoscopy and therapy

Alessandrini

Bruni

Piraccini

et al. 2021

Acad Dermatol Venereol

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The field of hair disorders is constantly growing. The most important hair diseases are divided in non‐ cicatricial and cicatricial ones. Non‐cicatricial alopecia are more frequent than cicatricial alopecia. The first step is to obtain a good history and physical examination. Laboratory testing is often unnecessary, while trichoscopy is fundamental for all hair diseases. Scalp biopsy is strongly suggested in cicatricial alopecia and in doubtful cases. Androgenetic alopecia, alopecia areata, telogen effluvium, trichotillomania are common causes of non‐ cicatricial alopecia. Frontal fibrosing alopecia, discoid lupus erythematosus, lichen planopilaris, follicullitis decalvans are some of the most common forms of cicatricial hair loss. Many treatments are available, and a prompt diagnosis is very important for the prognosis.

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“…Several studies using questionnaires on AGA administered to patients and doctors have been reported [26][27][28]. We evaluated the questionnaires administered to patients with AGA who were treated with finasteride for 10 years.…”

Section: Subjective Evaluation -Questionnairementioning

confidence: 99%

Long-term (10-year) efficacy of finasteride in 523 Japanese men with androgenetic alopecia

Yanagisawa¹,

Fujimaki²,

Takeda³

et al. 2019

Clin Res Trial

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Finasteride is a standard medical treatment for androgenetic alopecia; however, no long-term study of up to 10 years has been performed in Japan. Therefore, we evaluated the efficacy and safety of 1 mg/day finasteride in 532 Japanese men who were treated for androgenetic alopecia for 10 years. We performed subjective evaluations, using questionnaires administered to patients, in addition to the objective evaluation by doctors. The efficacy was assessed using the Norwood-Hamilton scale and modified global photographic assessment score, the standardized 7-point rating score using scalp photographs. For the Norwood-Hamilton classifications, stages IIa and IIv were combined as II, IIIa and IIIv were combined as III, IVa was combined as IV, and Va was combined as V. The proportions of patients with improvement (score ≥ 5) and prevention of disease progression (score ≥ 4) were 91.5% and 99.1%, respectively. The Norwood-Hamilton classification grading improved by approximately 1 grade from 3.35 ± 1.11 to 2.55 ± 1.30 after the 10-year treatment. The groups that showed Norwood-Hamilton: I/II/III and IV/V/VI/ VII at the first visit showed statistically significant differences in the modified global photographic assessment score at the 10-year treatment subjective evaluation (6.27 ± 0.62 vs 5.52 ± 0.78, P<0.001). Furthermore, the quantitative analysis of the objective evaluation using the questionnaire was also significantly different (P<0.001). During the study period, no serious adverse reaction was recognized. Long-term (10-year) treatment with 1 mg/day finasteride in Japanese men with androgenetic alopecia showed high efficacy in subjective and objective evaluations.

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Drug Treatment for Androgenetic Alopecia: First Italian Questionnaire Survey on What Dermatologists Think about Finasteride

Cited by 10 publications

References 41 publications

Post-finasteride syndrome: a surmountable challenge for clinicians

Post-finasteride syndrome: a surmountable challenge for clinicians

Common causes of hair loss – clinical manifestations, trichoscopy and therapy

Long-term (10-year) efficacy of finasteride in 523 Japanese men with androgenetic alopecia

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