Oral Finasteride presents with sexual-unrelated withdrawal in long-term treated androgenetic alopeica in men (AGA): A cross-sectional study on 100 patients

1. ORAL FINASTERIDE PRESENTS WITH SEXUAL-UNRELATED WITHDRAWAL IN LONG-TERM TREATED
ANDROGENETIC ALOPECIA IN MEN (AGA): A CROSS-SECTIONAL STUDY ON 100 PATIENTS
Background: The side-effects of oral Finasteride (FT) (1mg/day) and topical 5% Mi-
noxidil (M5) to treat Male Androgenetic Alopecia (AGA) have been described and pub-
lished. Nevertheless, there is no specific study evaluating the incidence of adverse ef-
fects of combined M5+FT as compared to M5 single-therapy, and the reasons for long-
term therapy self-discontinuation.
Objectives: To evaluate long-term adverse effects and causes of long-term therapy
withdrawal in AGA patients treated with M5+FT versus M5 without FT.
Methods: 130 AGA patients with a minimum 2-year follow-up (range: 2-5 years) volun-
teered to complete a 15 side-effects questionnaire. All patients’ responses were classi-
fied according to the following scale score: “never”, “rarely”, “sometimes”, “often” and
“all the time”. Adverse effect was considered in the presence of “often” or “all the time”
responses. Mean age of patients was 35.1 ± 11.2 years. Retrospectively, 100 patients
received combined M5+FT and 30 patients received M5 single-therapy.
Results: Increased body hair was different between groups: M5: 6.6%, M5+FT: 4%
(P<.03). The incidence of scalp related clinical manifestations such as pruritus, scalp
pain, or hair color change was also higher in M5 single-therapy patients, although the
differences did not reach statistical significance (Table 1). Erectile dysfunction (3%) di-
minished libido (4%) and reduced ejaculation (7%) were present in M5+FT patients but
were absent in M5 single-therapy patients (Table 2). Only 1 out 100 M5+FT patients
quit long-term therapy due to sexual adverse effects (diminished libido). The main
causes for therapy withdrawal were: FT (lack of positive results 11%) M5 (side-effects
4.6%) (P<.03).
Conclusions: We may conclude that FT withdrawal due to sexual side-effects is infre-
quent in long-term treated AGA. Minoxidil and Finasteride present with a different pat-
tern of therapy discontinuation in long-term treated AGA patients.
*
N Perez-Mora1
, C Velasco1
, F Bermudez1
1
Medical Science Research, Svenson Medical, Madrid, Spain
P029
76,6 80,0
16,7 11,0
6,7 6,0
3,0
0%
20%
40%
60%
80%
100%
M5 M5 + FT
Erectile Dysfunction
Often
Sometimes
Rarely
Never
70,0 67,0
20,0
17,0
10,0
9,0
4
3
0%
20%
40%
60%
80%
100%
M5 M5 + FT
ReducedEjaculation
All the time
Often
Sometimes
Rarely
Never
70 73,0
20 15,0
10 8,0
2,0
2,0
0%
20%
40%
60%
80%
100%
M5 M5 + FT
DiminishedLibido
All the time
Often
Sometimes
Rarely
Never
60,0
73,0
30
17,0
6,7 9,0
13,3
0%
20%
40%
60%
80%
100%
M5 M5 + FT
Scalp Pain
All the time
Often
Sometimes
Rarely
Never
43,3 49,0
33,3 21,0
16,7 27,0
3,3 3,0
3,3
0%
20%
40%
60%
80%
100%
M5 M5 + FT
Scalp Pruritus
All the time
Often
Sometimes
Rarely
Never
56,7
78,0
20,0
10,016,7
8,0
6,6 2
2
0%
20%
40%
60%
80%
100%
M5 M5 + FT
Body Hair Increase
All the time
Often
Sometimes
Rarely
Never
73,4
85
13,3
1110
3,0
3,3 1
0%
20%
40%
60%
80%
100%
M5 M5 + FT
Hair Color Change
Often
Sometimes
Rarely
NeverM5, Minoxidil single-therapy (n = 30 patients) • M5+FT, Combined Minoxidil and Finasteride
therapy (n = 100 patients) • *Fisher’s exact test: Adverse effect included “often” or “all the
time” responses • #
U-Mann Whitney Test: included all scale-score responses • NS: Not sig-
nificant difference
M5, Minoxidil single-therapy (n = 30 patients) • M5+FT, Combined Minoxidil and Fi-
nasteride therapy (n = 100 patients) • *Fisher’s exact test: Adverse effect included
“often” or “all the time” responses • #
U-Mann Whitney Test: included all scale-score
responses • NS: Not significant difference
Long-term Minoxidil effects
Long-term Finasteride effects
M5 (n = 30 patients), M5+FT (n = 100 patients), Exact Fisher’s Test: NS.,Mann - Whitney U Test: NS.
M5 (n = 30 patients), M5+FT (n = 100 patients), Exact Fisher’s Test: NS.,Mann - Whitney U Test: NS. M5 (n = 30 patients), M5+FT (n = 100 patients), Exact Fisher’s Test: NS.,Mann - Whitney U Test: NS.
M5 (n = 30 patients), M5+FT (n = 100 patients), Exact Fisher’s Test: NS.,Mann-Whitney U Test: P<.03
M5 (n = 30 patients), M5+FT (n = 100 patients), Exact Fisher’s Test: NS., Mann - Whitney U Test: NS.
M5 (n = 30 patients), M5+FT (n = 100 patients), Exact Fisher’s Test: NS., Mann - Whitney U Test: NS.
M5 (n = 30 patients), M5+FT (n = 100 patients), Exact Fisher’s Test: NS., Mann - Whitney U Test: NS.
91,5%
85%
3%
3,8% 11%
4,6% 1%
0
20
40
60
80
100
Minoxidil Finasteride
Causes of Long-term Therapy Withdrawal
Side Effects
Lack of Results
Positive Results
Maintained Therapy
%
n=130 n=100
Chi-square Test: P<.02
Poster download:
Adverse Effect M5 M5+FT P value* P value
#
Erectile Dysfunction 0% (0/30) 3% (3/100) NS NS
Diminished Libido 0% (0/30) 4% (4/100) NS NS
Reduced Ejaculation 0% (0/30) 7% (7/100) NS NS
Urinary urgency 0% (0/30) 2% (2/100) NS NS
Gynecomastia 0% (0/30) 0% (0/100) NS NS
Decreased Body Hair 0% (0/30) 1% (1/100) NS NS
Depression 6.6% (2/30) 2% (2/100) NS NS
Weakness 0% (0/30) 1% (1/100) NS NS
Insomnia 3.3% (1/30) 5% (5/100) NS NS
Contact: nperezmora@svenson.es
Adverse Effect M5 M5+FT P value* P value
#
Scalp Pruritus 6.6% (2/30) 3% (3/100) NS NS
Hair Color Change 3.3% (1/30) 1% (1/100) NS NS
Scalp Pain 3.3% (1/30) 1% (1/100) NS NS
Body Hair Increase 6.6% (2/30) 4% (4/100) NS <.03
Hypotension 3.3% (1/30) 0% (0/100) NS NS
Palpitations 0% (0/30) 0% (0/100) NS NS