In the News – Propecia’s Bad PR for Merck
Snippet from the article:
Merck (MRK) is experiencing some rough PR issues on its hair-loss drug Propecia following a study that suggests up to 15 percent of men taking the drug might experience some form of sexual dysfunction. For years, the warning label on Propecia has said that only 2 percent of men might experience erectile dysfunction while using the drug, and if users stop taking the pills everything returns to normal
Read the full story — Why Merck’s Hair Loss Drug Could Make Its Income Statement Go, Um, Limp
This article is from a business-oriented site, so it examines more of the bad press and how it may harm Merck’s stock valuation. And with the Propecia patent expiring in a couple years, Merck would probably like to keep the damage control to a minimum. That being said, I believe the study they reference is actually just an analysis of existing studies. Still, articles like this need to be seen by everyone. Knowledge is power.
I tell those patients who have sexual side effects to see me about reducing the dose. The problem of course, is that if you stop the medication the hair loss will continue.
I’m thinking about taking finasteride for BPH and thinning hair, but these kinds of studies are worrying. I don’t want to seem overly paranoid, but the large Pharmaceutical companies have a long history of selective publishing of data and downplaying of side effects (as well as marketing drugs for uses they haven’t been approved or tested for, etc). I think the 2% was from the initial studies submitted to the FDA whereas the 15% is from a meta-analysis of a whole range of studies. The most worrying are the reports of permanent erectile dysfunction that persists even after people stop taking the drug.
In my Doctor’s opinion erectile dysfunction affects a lot more than 2% of people taking the drug, he thinks the rate is around 1 in 5. In some ways the idea that you can suppress dihydrotestosterone and not have a high risk of sexual side effects doesn’t make sense. For example Mantzoros et al. in the British Medical Journal (1995; 310 : 1289) found that differences in dihydrotestosterone was a major predictor of sexual activity in young men.
What I would like to see are more studies of the side effects of the drug. Also more studies on the relationship between dose and side effects. The work of Dr Sherman Frankel suggests that a smaller dose of finasteride may have a similar effect on DHT levels to a larger dose, and hence patients may be able to get away with a smaller dose such as 0.2mg/day. Whether the side effects are lower at the reduced dose is not readily apparent. In any event, even though finasteride has been studied quite a lot, there seem to remain large gaps in our understanding of both the drug and more generally in the role of DHT.
Anyway this is a good Blog, which I think tries hard to present information in an objective fashion.