Dutasteride in androgenic alopecia (AGA)

Dutasteride in androgenic alopecia:

• dutasteride is a dual 5alpha-reductase
  • has been used for the treatment of male androgenetic alopecia
    • evidence shows that dutasteride seems to provide a better efficacy compared with finasteride in treating an drogenetic alopecia. The two drugs appear to show similar rates of adverse reactions, especially in sexual dysfunction (1)
      
      
    • a prospective study investigating sexual dysfunction associated with dusteride use for androgenic alopecia in men found (2):
      • incidence of sexual adverse events was approximately twofold higher in the dutasteride group (16%) than the placebo group (8%) during the double-blind period; the overall incidence of sexual adverse events was lower (5%) during the open-label period
      • all adverse events were mild to moderate in severity and considered treatment-related
      • adverse events resolved while on study treatment or after the end of treatment and did not lead to treatment discontinuation.
        
        
• comparing treatments for male androgenic alopecia
  • analysis of 23 trials indicate 5mg/d oral dutasteride has highest probability of being most efficacious treatment, followed by (in decreasing order of efficacy): 5mg/d oral finasteride (OF), 5mg/d oral minoxidil (OM), 1mg/d OF, 5% topical minoxidil (TM), 2% TM, & 0.25mg/d OM (3)

Reference:

• 1Zhou Z, Song S, Gao Z, Wu J, Ma J, Cui Y. The efficacy and safety of dutasteride compared with finasteride in treating men with androgenetic alopecia: a systematic review and meta-analysis. Clin Interv Aging. 2019;14:399-406. Published 2019 Feb 20. doi:10.2147/CIA.S192435
• 2. Tsai TF, Choi GS, Kim BJ, et al. Prospective randomized study of sexual function in men taking dutasteride for the treatment of androgenetic alopecia. J Dermatol. 2018;45(7):799-804. doi:10.1111/1346-8138.14329
• 3. Gupta AK, Venkataraman M, Talukder M, Bamimore MA. Relative Efficacy of Minoxidil and the 5-alpha Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients: A Network Meta-analysis. JAMA Dermatol. Published online February 02, 2022. doi:10.1001/jamadermatol.2021.5743