In the News – Study Finds Dutasteride More Effective than Finasteride At Treating Hair Loss
Snippet from the article:
Daily treatments of dutasteride 0.5 mg were more effective than finasteride 1 mg daily or placebo in increasing hair count and width in men with androgenetic alopecia, according to recent study results.
Researchers randomly assigned 917 men, aged 25 to 50 years with androgenetic alopecia, to dutasteride at 0.02 mg/day (n=185), 0.1 mg/day (n=188), or 0.5 mg/day (n=184), finasteride at 1 mg/day (n=179) or placebo (n=181) for 24 weeks. Hair count in a 2.54-cm diameter was the primary endpoint, while hair count (1.13-cm diameter) and width, photographic assessments by investigators and panel, change in stage and health outcomes also were assessed.
Researchers observed that in patients assigned dutasteride, hair count and width increased dose-dependently. At week 24, dutasteride 0.5 mg increased hair count (P=.003) and width (P=.004) in a 2.54-cm diameter and improved hair growth (frontal view, panel photographic assessment; P=.002) compared with finasteride and placebo (P<.001, all).[/bq] Read the rest — Dutasteride superior to finasteride in restoring hair in male alopecia patients
You can read the study abstract here.
There are still the looming questions about sterility, which have not been addressed in this study. Dutasteride may have more such side effects, as have been reported with the higher dosage for treating prostate issues. Either way, if a doctor prescribes this off-label for treating hair loss, that is a decision between physician and patient.
This is an interesting study, but it already states what a lot of us hair loss sufferers already know, that dutasteride is better but nobody knows the long term side effects of this drug. Most of what I have read online about people’s experience with the drug has been somewhat positive. I have read that people lost more hair on the drug and never grew the hair lost back. However, most of the studies I have read had to do with grown men well into their late 30’s, 40’s and even 50’s. Nothing regarding anybody under 35 or in their 20’s.
Funny thing is, how come when this study was done, they didn’t also indicate the percentage of people who had side effects or if any did at all. They did not care who had side effects? It always seems every time a dustasteride study is done, side effects are conveniently left out!
While this seems to be a well-conducted study, the abstract in the link above surprisingly doesn’t contain any safety results. One reader has understandably already mistaken the abstract for the full published study paper and wondered why ‘when the study was done, they didn’t also indicate the percentage of people who had side effects or if any did at all?” Blog readers are encouraged to look at the entire paper for full study safety results. But, because most readers tend to be focused (in my opinion excessively) on the possible sexual side effects of drugs, I will summarize some of the study safety results. Please note that the incidence of adverse events during the study for sexual-related events below represent the number of patients with the event/number of patients receiving the study drug:
Decreased libido: 2/181 (1%) placebo; 10/185 (5%) dutasteride 0.2 mg; 9/188 (5%) dutasteride 0.1 mg; 6/184 (3%) dutasteride 0.5 mg; 9/179 (5%) finesteride 1 mg
Sexual dysfunction (otherwise undefined): 1/181 (0.6%) placebo; 30/185 (2%) dutasteride 0.2 mg; 2/188 (1%) dutasteride 0.1 mg; 2/184 (1%) dutasteride 0.5 mg; 2/179 (1%) finesteride 1 mg
Loss of libido: 0/181 (0%) placebo; 2/185 (1%) dutasteride 0.2 mg; 2/188 (1%) dutasteride 0.1 mg; 0/184 (0%) dutasteride 0.5 mg; 1/179 (0.6%) finesteride 1 mg
Libido disorder (otherwise not defined): 0/181 (0%) placebo; 0/185 (0%) dutasteride 0.2 mg; 0/188 (0%) dutasteride 0.1 mg; 1/184 (0.5%) dutasteride 0.5 mg; 0/179 (0 %) finesteride 1 mg
Total of above for any altered libido: 3/181 (1.7%) placebo; 15/185 (8%) dutasteride 0.2 mg; 13/188 (6.9%) dutasteride 0.1 mg; 9/184 (5%) dutasteride 0.5 mg; 12/179 (6.7%) finesteride 1 mg
Impotence (either erectile dysfunction or organic erectile dysfunction): 7/181 (4%) placebo; 8/185 (4.3%) dutasteride 0.2 mg; 7/188 (3.7%) dutasteride 0.1 mg; 10/184 (5.4%) dutasteride 0.5 mg; 11/179 (6.1%) finesteride 1 mg
Ejaculation disorders: 6/181 (3.3%) placebo; 4/185 (2.2%) dutasteride 0.2 mg; 9/188 (4.8%) dutasteride 0.1 mg; 6/184 (3.3%) dutasteride 0.5 mg; 7/179 (3.9%) finesteride 1 mg
Several guidelines for those unfamiliar with interpreting clinical trial safety data:
1) An adverse event is any untoward new event or change from a preexisting condition regardless of duration of the event (5 minutes vs. 6 months), its intensity (mild to severe), its suspected relationship to the study drug vs. something else, or seriousness.
2) Consider the placebo-adjusted rates when looking at incidence of events. For example, the incidence of ejaculatory disorders was in 3.3% of the men receiving placebo and 3.9% of the men receiving finesteride. So, the “placebo-adjusted†incidence of ejaculatory disorders in men receiving finesteride was essentially less than 1%.
3) Adverse events should are issues reported by study patients to the study physicians. They are not “rates†that are set in stone and can vary from what study to another. They are guidelines. The larger the study, the more likely the event rates will reflect the “true ratesâ€.
BiotechMD
Thank you for clarification. Yeah, I had only read the abstract and not the whole article. What that being said, I hope the accuracy of the side effects are valid and not altered like they did for finasteride when they said only 2% had side effects when in reality there was a larger population of people reporting side effects.
I have been one of the lucky ones that I haven’t had any serious side effects. My only concern is with dutasteride, that long term effects and the fact that many people have reported losing more hair on dutasteride and not growing it back, and then going back to finasteride with no luck at all.
Chris
The percentage with side effects is not significantly greater than what was initially reported. You need to factor bias into the equation. Most people who do experience side effects are the ones that are likely to resort to forums and post about it, where as the majority of the people who don’t won’t post about them being “side-effect” free, only when asked.
Lastly,
With regards to your last comment about people not being able to gain back what they lost after switching back to propecia.
Think about it this way. Something must have compelled them to switch to dutasteride – i.e. their hairloss was aggressive, and finasteride wasn’t doing the job. When they switched over to dutasteride, they CONTINUED to lose hair, blame it on the drug and then switched back to finasteride and claim they couldn’t regrow what they lost on dustasteride. The key is, their hair loss was aggressive and both finasteride and dutasteride weren’t able to prevent it… it wasn’t a cause of the drug iteself!
I guess it is the long term side effects on dutasteride that we all want to know. If I remember correctly there was a study conducted back in 2007-08 in China, about dustasteride being in phase III trials. I am probably getting my dates wrong and my location, but I remember it was posted here. All I know, it was done a while back and I would like to know the results of that. I am sure they have some data about the efficacy and the long term side effects.
Back to the thing about losing more hair on dutasteride. Now, whatever I have read has been on the forums and I haven’t really met or seen anybody on the drug. So, for all we know people posting in forums could be BSing. I do recall reading a few posts where people switched to dutasteride and shed a whole bunch of hairs that never grew back even while they continued on the drug, they then switched back to finasteride and had minor success. Now, I don’t know for sure if this is true, but I am sure there are people who can let us know if it is worth switching to dutasteride. I would really like to know because I know I have lost some ground while being on finasteride. I been on the drug for well over a decade but I am debating whether or not to switch. I don’t want to play doctor on myself and regret my decision if I switch.