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

Abstract

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.

Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial

“…The clinical efficacy of oral finasteride for treating AGA is well established. Long‐term studies of oral finasteride 1 mg in men with AGA demonstrated slower progression of hair loss or enhanced hair growth, compared with baseline and/or placebo, as early as 3 months after starting the treatment and extending for 5–10 years 6−10 . Although oral finasteride is generally well tolerated, 5 in some patients 5α‐reductase inhibition is associated with sexual adverse effects (erectile dysfunction, ejaculation problems, decreased libido), 11 and increased risk of depression, 12 prompting health authorities in some countries to include warnings in the product labelling 13 .…”

“…Long‐term studies of oral finasteride 1 mg in men with AGA demonstrated slower progression of hair loss or enhanced hair growth, compared with baseline and/or placebo, as early as 3 months after starting the treatment and extending for 5–10 years. 6 , 7 , 8 , 9 , 10 Although oral finasteride is generally well tolerated, 5 in some patients 5α‐reductase inhibition is associated with sexual adverse effects (erectile dysfunction, ejaculation problems, decreased libido), 11 and increased risk of depression, 12 prompting health authorities in some countries to include warnings in the product labelling. 13 Topical administration of finasteride offers the potential to reduce systemic effects related to its mechanism of action by preferentially inhibiting 5‐α reductase in the scalp, as has been suggested in recent years.…”

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

“…In a study of 399 patients, dutasteride blocked 98.4 ± 1.2% of DHT at 5 mg/d dose compared to 70.8 ± 18.3% with the same finasteride dose 32 . The long‐term safety of finasteride, over a period of 10 years has been documented in studies 33,34 . Recent reports about postfinasteride syndrome have created a fear among patients seeking treatment.…”

Long-Term (Over 10 Years) Evaluation of Efficacy and Safety of Finasteride in Japanese Men with Androgenetic Alopecia: Summary of Three Investigations

“…6 The third investigation, "Long-Term (10-Year) Efficacy of Finasteride in 523 Japanese Men with Androgenetic Alopecia," was evaluated from December 2005 to January 2009. 5 The same patients were included in the three investigations, but each study period was completely different. In two of the investigations, adverse reactions were assessed through self-reported evaluations by patients.…”

“…[1][2][3] Although finasteride has been globally used for more than 20 years, only a few investigations for up to 10 years have been demonstrated worldwide. 4,5 The authors have previously demonstrated three investigations of efficacy and safety of large-scale and long-term AGA treatment with finasteride (3,177 cases in 2.5 years, 801 cases in 5 years, and 532 cases in 10 years, respectively). [5][6][7] The objective of this article is to summarize the three investigations, and to consider them as a base for future studies over the next 20 to 30 years or more.…”