Use Of Finasteride Research Articles

Development and Evaluation of Herbal Hair Serum: A traditional way to Improve Hair Quality

Background: In the mammalian system, the hair follicle is known to be the most significant organ that determines appearance, gender distinction, provides intense temperature protection, and plays a role in self-defense. The younger generations have begun to suffer from extreme hair loss problems due to many lifestyle-related changes such as fatigue, anxiety, intake of junk foods, use of different hairstyling/coloring methods, etc. The loss of hair is not temporary in most cases, but it results in alopecia. Many people suffering from hair loss are in search of multiple treatments due to extreme anxiety and tension, from mythology to traditional and therapeutic healing to the use of minoxidil and finasteride. To improve hair growth and to prevent hair loss, hair root activation is required. Objective: The present study was intended to use different herbs to formulate herbal hair serum for general purposes (hair application). Methods: Crude herbs are obtained from nearby regions. In order to obtain the extract, the required part of herbs, such as Citrus sinensis peel, Zingiber officinale roots, and Linum usitatissimum seeds, Nigella sativa, and Trigonella foenum-graecum were specifically weighed and dispensed in water, boiled, allowed to cool, and then filtered. To the filtrate, castor oil and vitamin E were added. The formulated herbal hair serum was tested, and different criteria were determined and recorded in this text, such as physical appearance, viscosity, pH, homogeneity, eye sensitivity (Draize eye test), hair growth activity, hair weight, stability test, etc. Results: Prepared herbal hair serum was found to be pale brown in color with pseudoplastic behavior. The texture of the formulation was smooth and lubricative, and the pH was within the acceptable limit. Herbal hair serum revealed good hair growth as well as hair weight after application with minor sensitivity for the first time. The formulation was found to be stable for seven days. Conclusion: Herbal cosmetics are still commonly used by average citizens because of fewer side effects and greater protection and safety profile. Current research has revealed that herbal formulations are effective in enhancing hair consistency.

The effect of short-term use of finasteride versus cyproterone acetate on perioperative blood loss with monopolar transurethral resection of prostate

BackgroundPerioperative bleeding is the most common complication related to transurethral resection of prostate; the aim of the study was to compare the effect of pre-operative use of finasteride versus cyproterone acetate (CPA) on blood loss with monopolar TURP.MethodsThis prospective randomized controlled study was conducted on (60) patients with BPH underwent monopolar TURP between July 2019 and July 2020. Patients were distributed into three equal groups; CPA group: 20 patients received cyproterone acetate 50 mg tab BID for two weeks before TURP, finasteride group: 20 patients received single daily dose of finasteride 5 mg for two weeks before TURP, control group: 20 patients received no treatment before TURP, all patients underwent monopolar TURP, and then histopathological examination of the resected tissues was done with assessment of the microvascular density of the prostate.ResultsOur study showed that there was significant decrease in intraoperative blood loss and operative time in CPA and finasteride groups in comparison with control group (p = 0.0012) (p < 0.0001), respectively, significant decrease in post-operative Hb and HCT value in finasteride and control groups in comparison with CPA group (p < 0.01), significant increase in specimen weight in CPA group compared to other groups (p < 0.01), and there was also significant decrease in microvascular density in CPA group in comparison with other groups (p < 0.01).ConclusionCyproterone acetate is more effective than finasteride in decreasing perioperative bleeding with TURP by decreasing microvascular density of the prostate.

Use of Topical Finasteride Vs Systemic Finasteride in Male Pattern Baldness

In this study we have analyzed the use of finasteride which is a type P-selective 5a-reductase inhibitor. By decreasing dihydroxytestestrone (DHT) level, it is found to be effective in the treatment of male androgenic alopecia. In this study, we compared the effect of topical vs. systemic finasteride in the treatment of androgenic alopecia. Our study is a randomized clinical trial study having 30 male patients. They have come for alopecia treatment at Nesam hospital, Coimbatore, India. We have selected male patients with androgenic alopecia and divided them into two groups (A, B), randomly having 15 patients in each group. For group A, Topical finasteride (0.1%) with minoxidil (5%) solution was given. Group B patients received topical minoxidil with oral finasteride (1mg) tablets. All patients were regularly followed up till the end of 6 months. A Patient had a first review in the first week followed by monthly follow up. Following parameters were taken into account: size of bald area, total hair count, and terminal hair. Data was analyzed by Chi-square statistical test. Each month the terminal hair, size of bald area and hair count between the two groups were compared. In the initial few months group, A showed good improvement. But Serial measurements indicated that a significant increase in hair counts and terminal hair counts is seen in both groups. This study showed that on long term follow-up of more than 3 months, both topical and systemic finasteride groups had similar results.

Finasteride interferes with prostaglandin-induced CatSper signalling in human sperm.

Ca2+ signalling controls human sperm functions necessary for successful fertilization. Multiple endocrine-disrupting chemicals have been found to activate the CatSper Ca2+ channel and thereby interfering with Ca2+ signalling in human sperm. Finasteride is prescribed to men in the fertile age to treat hair loss and its use has been associated with impaired male fertility. Due to the structural relatedness of finasteride to the endogenous CatSper ligand progesterone, this study aimed to investigate whether finasteride affects human sperm in a progestogen-like manner. The effect of finasteride on Ca2+ signalling via CatSper in human sperm was investigated in cell suspensions by single-cell imaging. Additionally, effects on sperm penetration into viscous medium and acrosome reaction were assessed. Finasteride alone caused a minor transient rise in the intracellular, free Ca2+ concentration ([Ca2+]i) at physiologically relevant concentrations. Ca2+ signals induced by PGE1 were inhibited by finasteride displaying mixed type of inhibition consistent with multiple binding sites. Finasteride did not interfere with progesterone-induced Ca2+ signalling and no effect on acrosome reaction or sperm viability was found. Finasteride significantly decreased PGE1-induced penetration into viscous medium but in concentrations above what is measured in blood and seminal fluids during regular finasteride administration. In conclusion, the use of finasteride may affect Ca2+ signalling in human sperm through an interaction with the PGE1-binding site, but to which extend it alters the chances of a successful fertilization needs further investigation. It remains to be investigated whether finasteride administration may give rise to side effects by interfering with prostaglandin signalling elsewhere in the human body.

Finasteride Use and Risk of Bladder Cancer in a Multiethnic Population.

Finasteride use has been associated with a reduced incidence of bladder cancer. However, the majority of studies have been conducted primarily in East Asian or White populations. Given differences in the incidence of bladder cancer among racial/ethnic groups, it is important to determine whether the effect of finasteride use on bladder cancer varies by race/ethnicity. We identified all patients with a diagnosis of benign prostatic hyperplasia between 2000 and 2016 at our academic health center in Bronx, New York via an electronic medical record database. We then identified patients who were prescribed finasteride, and those who developed bladder cancer during followup. We used competing risk analysis to examine associations of finasteride use with risk of bladder cancer, adjusting for age, smoking and race/ethnicity. We identified 42,406 patients with benign prostatic hyperplasia (average±SD age 67±12.9 years), of whom 27.7% were Black and 14.8% were Hispanic. Finasteride was prescribed in 5,698 patients (13.4%). Bladder cancer was diagnosed in 84 of 5,698 finasteride users (1.5%), compared to 762 of 36,708 nonusers (2.1%, log-rank p=0.003). Finasteride was associated with a 36% reduction in risk of bladder cancer (HR: 0.64, 95% CI: 0.51-0.80; p <0.0001) among all patients. When data were stratified by race/ethnicity, finasteride use was associated with a reduction in risk of bladder cancer in White men (HR: 0.61, 95% CI: 0.43-0.86; p=0.005) and Hispanic men (HR: 0.44, 95% CI: 0.21-0.90; p=0.026), but there was no association among Black men (HR: 1.01, 95% CI: 0.67-1.51; p=0.964). Our study corroborates previous findings that men who are on finasteride have a lower bladder cancer incidence. However, the reduction in risk was seen only in White and Hispanic men, but not among Black men. Therefore, race/ethnicity represents an important stratification factor for future larger studies on finasteride as chemoprevention for bladder cancer.

Effect of preoperative finasteride on perioperative blood loss during transurethral resection of the prostate and on microvessel density in patients with benign prostatic hyperplasia: An open label randomized controlled trial.

Objective:Transurethral resection of the prostate (TURP) is a common procedure for the treatment of benign prostatic hyperplasia (BPH). Previous studies on the effect of 5-alpha reductase inhibitors on perioperative blood loss in TURP and microvessel density (MVD) in the prostate are equivocal. We evaluated whether pretreatment with finasteride for 2 weeks before surgery can reduce perioperative blood loss in TURP and MVD in the prostate.Materials and Methods:Sixty-eight patients of BPH planned for TURP were randomized into two groups. The study group comprising 34 patients was treated with finasteride (5 mg/day) for 2 weeks and the placebo group comprising 34 patients received placebo for 2 weeks, before TURP. Blood loss was measured in terms of a reduction in the blood hemoglobin (Hb) and hematocrit (HCT) levels between preoperative values and 24 h after surgery. MVD was measured in the resected prostate tissue stained with anti-CD31 monoclonal antibody.Results:The reduction of Hb and HCT in the finasteride group was significantly lower than the reduction in the placebo group (P < 0.05). The artery (P = 0.005), vein (P = 0.05), and gland (P = 0.008) densities were significantly less in the finasteride group than in the placebo group. There was no significant correlation between blood loss and MVD.Conclusions:Our study suggests a clear advantage of the preoperative use of finasteride for 2 weeks by reducing the perioperative blood loss in TURP in patients with BPH. While there is a significant reduction in MVD in the prostate on treatment with finasteride, it is not clear that this is the mechanism of reduction in blood loss in TURP.

Does finasteride affect blood loss during monopolar transurethral resection of the prostate?

Objectives To evaluate the effect of preoperative finasteride on the surgical blood loss during monopolar transurethral resection of the prostate (TURP). BackgroundBenign prostatic hyperplasia (BPH) is one of the most common causes of lower urinary tract symptoms in elder men. Prophylactic measures have been employed to reduce perioperative bleeding, including preoperative 5α-reductase inhibitors administration. Finasteride and dutasteride can block the conversion of testosterone to dihydrotestosterone and have been used to treat BPH and BPH-related hematuria.Patients and methodsWe conducted a randomized controlled study at the Urology Department of Menoufia University Hospital, comparing the preoperative use of finasteride 5 mg over the intraoperative bleeding during TURP. A total of 90 patients with BPH with prostate size varying between 40 and 90 g assigned for a monopolar TURP surgery were randomly allocated into three groups: the first group as control, the second group used finasteride 5 mg for 2 weeks before surgery, and the third group used finasteride 5 mg for 4 weeks before surgery.ResultsThere was an insignificant difference between the three groups regarding age or associated comorbidities. Calculated blood loss was lower for the second and third groups in comparison with the control one (P = 0.046).ConclusionResults of our study elicit that treatment with finasteride for even 2 weeks before surgery significantly reduces surgical bleeding.

Review of selected endpoints in studies evaluating the effectiveness and efficacy of topical finasteride use for androgenetic alopecia

Androgenetic alopecia (AGA) is a disorder that worsens over the time. A metabolite of testosterone called dihydrotestosterone is implicated in the pathogenesis of AGA by exerting its effect on genetically predisposed hair follicles. Oral finasteride (FNS) targets this enzymatic step and is one of the two approved medications for the condition, the other one being topical minoxidil. This paper aimed to dissect the current literature on the endpoints chosen to measure the efficacy and effectiveness of using topical FNS for managing AGA. PubMed database was searched from October to November 2021 with the following terms including (\&amp;quot;Finasteride\&amp;quot;[Title] OR \&amp;quot;Finasteride\&amp;quot;[MeSH Terms]) AND (\&amp;quot;Local\&amp;quot;[Title] OR \&amp;quot;Topical\&amp;quot;[Title]). All human studies that investigated the use of topical FNS for AGA were included. Following the initial abstract scanning, studies that only investigated animal objects were excluded. Additionally, studies that did not have at least one clinical endpoint were overlooked. This review highlighted the available tools of hair evaluation in the reviewed literature. Objective tools represent the majority. These assessment methods were inconsistently applied across the reviewed studies, which as discussed earlier led to results that are hard to combine statistically. Considering these observations, future investigators are encouraged to make use of validated and standardized methods. Despite their growing significant subjective measures of hair growth on the other hand were not included in all the investigations.

Effects of dutasteride on prostate cancer incidence: A systematic review and meta-analysis

5-Alpha-reductase inhibitors (5-ARIs) are used in the treatment of benign prostate hypertrophy (BPH). 5-ARIs, such as finasteride and dutasteride, suppress the biosynthesis of dihydrotestosterone (DHT), a precursor of androgen, which is closely related to the incidence of prostate cancer (PCa). A previous meta-analysis demonstrated a relationship between finasteride use and the incidence of PCA. However, there have been no meta-analyses on the relationship between PCa and dutasteride alone. This meta-analysis was performed to examine the prevalence of PCa in adult males taking dutasteride. We searched PubMed for reports regarding PCa risk and dutasteride use. The study was conducted according to the PRISMA guidelines for systematic reviews and meta-analyses. The analytic hierarchy process (AHP) method was used to weight the studies. Odds ratios (ORs), 95% confidence intervals (CIs), and P-values were calculated using fixed- and random-effects models. A total of eight articles were included in the meta-analysis. The overall OR for both the fixed- and random-effects models was 0.669 and the 95% CI for the random-effects model (0.526–0.851; P = 0.006) was wider than that for the fixed effects model (0.548–0.817; P &lt; 0.001). This study confirmed that the incidence of PCa was significantly reduced by taking dutasteride.

16799 Similar efficacy of maintenance treatment of finasteride 1 mg every other month compared with finasteride 1 mg daily in Korean men with androgenetic alopecia after taking finasteride 1 mg daily for 1 year

Background: Finasteride has proved to be an effective treatment for men with AGA. Daily use of finasteride 1 mg for three months or more is necessary before benefit is observed. Also, treatments for AGA, including finasteride 1 mg, should be continued to treat AGA and maintain therapeutic effect.

Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride

There is ongoing controversy about the adverse events of finasteride, a drug used in the management of alopecia and benign prostatic hyperplasia (BPH). In 2012, reports started emerging on men who had used finasteride and either attempted or completed suicide. To investigate the association of suicidality (ideation, attempt, and completed suicide) and psychological adverse events (depression and anxiety) with finasteride use. This pharmacovigilance case-noncase study used disproportionality analysis (case-noncase design) to detect signals of adverse reaction of interest reported with finasteride in VigiBase, the World Health Organization's global database of individual case safety reports. To explore the strength of association, the reporting odds ratio (ROR), a surrogate measure of association used in disproportionality analysis, was used. Extensive sensitivity analyses included stratifying by indication (BPH and alopecia) and age (≤45 and >45 years); comparing finasteride signals with those of drugs with different mechanisms but used for similar indications (minoxidil for alopecia and tamsulosin hydrochloride for BPH); comparing finasteride with a drug with a similar mechanism of action and adverse event profile (dutasteride); and comparing reports of suicidality before and after 2012. Data were obtained in June 2019 and analyzed from January 25 to February 28, 2020. Reported finasteride use. Suicidality and psychological adverse events. VigiBase contained 356 reports of suicidality and 2926 reports of psychological adverse events (total of 3282 adverse events of interest) in finasteride users (3206 male [98.9%]; 615 of 868 [70.9%] with data available aged 18-44 years). A significant disproportionality signal for suicidality (ROR, 1.63; 95% CI, 1.47-1.81) and psychological adverse events (ROR, 4.33; 95% CI, 4.17-4.49) in finasteride was identified. In sensitivity analyses, younger patients (ROR, 3.47; 95% CI, 2.90-4.15) and those with alopecia (ROR, 2.06; 95% CI, 1.81-2.34) had significant disproportionality signals for increased suicidality; such signals were not detected in older patients with BPH. Sensitivity analyses also showed that the reports of these adverse events significantly increased after 2012 (ROR, 2.13; 95% CI, 1.91-2.39). In this pharmacovigilance case-noncase study, significant RORs of suicidality and psychological adverse events were associated with finasteride use in patients younger than 45 years who used finasteride for alopecia. The sensitivity analyses suggest that these disproportional signals of adverse events may be due to stimulated reporting and/or younger patients being more vulnerable to finasteride's adverse effects.

Is there a role for 5α‐reductase inhibitors in transgender individuals?

This commentary will explore the important clinical question regarding whether the antiandrogen class of 5α-reductase inhibitors should be considered as an effective and safe treatment option for transfeminine and/or transmasculine individuals. The use of finasteride in transfeminine individuals is based upon the theory that the goal of medical treatment is to reduce the concentrations of androgens, including dihydrotestosterone. Nonetheless, it is unclear that finasteride will have any additive clinical benefit once testosterone levels have already been lowered with standard treatment regimens (i.e. estrogen with spironolactone or cyproterone acetate). For transmasculine individuals, 5α-reductase inhibitors may be a potential treatment option for a subset with androgenetic alopecia but may come at the expense of impairing virilization driven by dihydrotestosterone. In the absence of efficacy and safety data on 5α-reductase inhibitors in gender diverse populations, clinicians should discuss this issue with patients who request or are contemplating their use.

Commentary Regarding the Effect of Long Term Use of Finasteride on Saudi Women.

In the following commentary, we provided discussions regarding an article bublished by Albasher et al. (2020) concerning the effects of long-term use of finasteride on women. They reported some adverse effects, including abnormal levels in the steroid hormones, irregular menstrual cycles, and heavy menstrual bleeding. Some concerns exist in the study mainly concerning the sample, particularly its size and composition. The authors recruited Saudi women. Thus, the findings cannot be generalized. Their study can be seen as a starting point in this regard. Even though the concerns can restrict the study, their study is still credible addressing critical issues that need to be taken seriously by other researchers and stakeholders.

Platelet‑rich plasma as a method of treatment of androgenetic alopecia in men — a case report

Androgenetic alopecia is a common condition, accounting for about 95% of all male hair loss. Standard therapeutic solutions recommend the use of minoxidil, finasteride, spironolactone, nutritional supplementation, phototherapy and hair transplant surgery. An increasingly popular alternative method that has been used in the case report is platelet rich plasma (PRP) mesotherapy characterized by autologous character, minimal invasiveness and no serious side effects. A series of 3 treatments was performed at 3-week intervals. The effects of using medical photographic documentation after completing a series of treatments.

Abstract A071: Use of finasteride in the Prostate, Lung, Colorectal and Ovarian Cancer Prevention (PLCO) Trial cohort: Effects of sociodemographic factors and a black box warning

Abstract Background: In 1992, finasteride, a 5α-reductase inhibitor, was approved by the Food and Drug Administration (FDA) for the treatment of benign prostatic hyperplasia (BPH). Finasteride also showed early signs of lowering prostate-specific antigen (PSA) levels, indicating that it may be useful for the prevention of prostate cancer. The Prostate Cancer Prevention Trial (PCPT) was conducted from 1994 to 2003 and showed that finasteride reduced overall prostate cancer incidence; however, it also appeared to increase the incidence of high-grade disease. Consequently, in 2011 the FDA issued a black box warning based in part on the PCPT results. Little is known, however, about the effect this warning had on finasteride use among men after 2011. The purpose of this study was to assess the use of finasteride, for BPH or other reasons, among a sample of Prostate, Lung, Colorectal, Ovarian Cancer Prevention Trial (PLCO) participants. Specifically, we wanted to assess the effects of sociodemographic characteristics (e.g., age, race/ethnicity) and BPH on finasteride use and the effect of the FDA's black box warning on finasteride use after 2011. Method: This was a retrospective longitudinal study. Men's age, race/ethnicity, and BPH status were ascertained from questionnaires. Medication use was ascertained from linkage to Medicare Part D claims data from 2010 to 2014. Results: The sample contained 14,044 PLCO men with at least one year of part D claims data. The majority self-identified as non-Hispanic white (12,429; 88.5%); 236 (1.7%) were black, 753 (5.4%) were Asian, and 239 (1.7%) were Hispanic. Median (25th/75th) age in 2010 was 73 years (69/28). From 2010 to 2014, 11% (n=1,590) of these men used finasteride at any time. Overall, 63% (n=1,005) of the men who used finasteride reported a diagnosis of BPH. Finasteride use increased steadily over time from 5.5% in 2010 to 8.5% in 2014. Conclusion: Overall use of finasteride from 2010 to 2014 was low, and mainly in men with BPH. Finasteride use increased after the FDA's 2011 black box warning; the effect of the warning is unclear. Citation Format: Jarrett A. Johnson, Paul F. Pinsky. Use of finasteride in the Prostate, Lung, Colorectal and Ovarian Cancer Prevention (PLCO) Trial cohort: Effects of sociodemographic factors and a black box warning [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A071.

Penile vascular abnormalities in young men with persistent side effects after finasteride use for the treatment of androgenic alopecia.

BackgroundThe constellation of persistent sexual, neurological, and physical adverse effects in patients who discontinue 5α-reductase inhibitors (5ARIs) has garnered recent concern. The objective of this study was to evaluate potential penile vascular changes and persistent adverse effects of 5ARIs in men treated for androgenic alopecia (AGA).MethodsThis was a prospective case-control study with 25 subjects with a history of 5ARI use for AGA and 28 controls. Patient self-reported questionnaires including the International Index of Erectile Function (IIEF), International Prostate Symptom Score (IPSS), Patient Health Questionnaire-9 (PHQ-9), the Epworth Sleepiness Scale (ESS) and the Androgen Deficiency in the Aging Male (ADAM) were used. Penile duplex Doppler ultrasound (PDDU) results were evaluated in men with a history of 5ARI use.ResultsA significant difference in total IIEF score between the 5ARI (median: 35; IQR: 29–43) and control group (median: 29; IQR: 27–32) (P=0.035) was observed. Seventeen 5ARI subjects (68%) had a vascular abnormality on PDDU. The median (IQR) for total IPSS score for the 5ARI group was 10 [5–16] compared to 3 [2–8] for the controls (P<0.01). The 5ARI group had a higher median total PHQ-9 score than controls [10 (6.5–16) vs. 1 (0–2) (P<0.001)]. Two subjects (8%) committed suicide during or after the study.ConclusionsWhile the sexual side effects of 5ARIs are well known, there may be persistent genitourinary, physical, psycho-cognitive, anti-androgenic and penile vascular changes after 5ARI discontinuation. Use of 5ARIs for treatment of AGA may lead to persistent sexual, genitourinary, physical, psycho-cognitive, and anti-androgenic sequelae even after cessation of 5ARI therapy.

Dietary Supplementation with a Low Dose of Finasteride Does Not Alter the Lipid Profile of Ldlr-Deficient Mice

Abstract Objectives Androgenic alopecia is characterized by a receding hairline and hair loss from the frontal scalp. This genetic condition affects approximately 80% of men and 42% of women. Finasteride is the only oral treatment currently approved by the FDA to prevent and treat androgenic alopecia, and it is currently prescribed to over nine million males in the US. Recent claims suggest that long-term use of finasteride could have detrimental health effects by affecting the lipid profile in people. Finasteride prevents the conversion of testosterone to its active metabolite dihydrotestosterone by inhibiting the type II 5 alpha-reductase, which is predominantly present in the hair follicle and the prostate. As a result, finasteride alters the systemic levels of testosterone and its derivative estradiol. Hormone homeostasis affects plasma lipid levels, therefore we hypothesize that supplementation with finasteride will affect systemic lipid profile in atheroprone low-density lipoprotein receptor (Ldlr−/−) mice fed a Western diet (high cholesterol, high fat). Methods We fed six-week-old male Ldlr−/-mice (10/group) fed a Western diet (control) or a Western diet supplemented with 10 mg Finasteride/kg diet for 12 weeks. We monitored body weight progression and food intake during the entire experiment. A week before harvesting the tissues, mice were fasted overnight to perform a glucose tolerance test. At the moment of sacrifice, final body weight and several tissues were collected such as the inguinal, retroperitoneal, and gonadal adipose tissues, skeletal muscle (gastrocnemius), and liver. Plasma was harvested to determine total cholesterol and triglyceride levels. Results Our data show that 12-week supplementation with a low dose of finasteride does not have a significant impact on food intake, body weight, or adiposity index. We did not observe any significant change in plasma lipids or glucose tolerance. Conclusions A low dose of finasteride supplemented for 12 weeks does not alter the lipid profile in the atheroprone Ldlr−/-mouse model, nor alters adiposity index. These data indicate that finasteride does not have detrimental effects on these metabolic parameters. Funding Sources U.S. Department of Agriculture (Multi-State grant project W4002).

Association of finasteride with prostate cancer

Background:The Prostate Cancer Prevention Trial has shown a protective effect of finasteride on prostate cancer, but it also showed that finasteride can increase the risk of high-grade prostate cancer. Several studies have investigated the relationship between finasteride and prostate cancer, but these studies have shown inconsistent results.Ethics:The protocol was approved by the institutional review board of each study center. Written informed consent will be obtained from all patients before registration, in accordance with the Declaration of Helsinki.Methods:We performed a systematic literature review and meta-analysis to assess the association between finasteride and prostate cancer. Systematic literature searches were conducted using PubMed, EMBASE, Science Direct/Elsevier, MEDLINE, CNKI, and the Cochrane Library up to October 2018 to identify studies that involved the relationship between finasteride and prostate cancer. Meta-analysis was performed using Review Manager and Stata software. Combined ORs were identified with 95% confidence intervals (95% CI) in a random or fixed effects model.Results:Eight studies were identified, including 54,335 cases of patients that used finasteride and 9197 patients who served as placebo controls. Our results illustrate that there is a significant correlation between finasteride use and prostate cancer with combined ORs of 0.70 [0.51, 0.96]. A significant correlation between finasteride use and high-grade prostate cancer was also observed with combined ORs of 2.10 [1.85, 2.38].Conclusions:This study confirms that finasteride significantly reduced the risk of prostate cancer; however, the malignant degree of prostate cancer was increased. Studies with larger sample sizes are needed to better clarify the correlation between finasteride use and prostate cancer.

Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date.

The currently approved treatment for female pattern hair loss (FPHL) includes topical minoxidil administration; however, this treatment fails to achieve hair regrowth in some patients. Finasteride, a selective 5α-reductase inhibitor (5-ARI), may be considered as an alternative treatment. However, because of its potential teratogenic effects, clinical studies and use of finasteride for FPHL are limited. In this review, we aim to summarize the literature regarding the pharmacology, clinical efficacy, and adverse effects of oral finasteride for the treatment of FPHL and to provide novel therapeutic options including topical finasteride and dutasteride, a new generation 5-ARI, for the treatment of FPHL.

Prolonged use of finasteride-induced gonadal sex steroids alterations, DNA damage and menstrual bleeding in women.

The aim of the present study was to examine the effect of prolonged use of finasteride on serum levels of dihydrotestosterone (DHT), estradiol (E2), progesterone, testosterone and androstenedione in women during the menstrual period. Further, to screen and compare the 5α-reductase activities through the expression of SRD5A1, SRD5A2 and AR gene and to determine the level of VEGF, VKOR and SAA gene expression and DNA damage. A total of 30 Saudi women aged between 25 and 35 years were enrolled in the study. The selected women were divided into two groups. The first group (n = 15) received 5 mg finasteride/day for prolonged period of one year and second group (n = 15) was taken as a healthy control. ELISA technique was used for measuring the serum levels of the targeted hormones, and Comet assay was used for checking the DNA integrity. Our findings revealed significant decrement of DHT, E2, progesterone and androstenedione levels and elevated levels of testosterone in group treated with daily oral doses of 5 mg finasteride/day compared with the control subjects. mRNA expression suggested that finasteride has concrete effects on the gene expression of the selected genes from the treated group in comparison with the control group. In addition, finasteride induced DNA damage, and heavy menstrual bleeding was noted in women treated with finasteride. In conclusion, the present findings revealed that finasteride has adverse health effects in women associated with gonadal sex steroids alterations, DNA damage and heavy menstrual bleeding with no consensus in the treatment of androgenetic alopecia in women.