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-Mora

1, C Velasco

1, F Bermudez

1

1Medical 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

20,017,0

10,09,0

4

3

0%

20%

40%

60%

80%

100%

M5 M5 + FT

Reduced Ejaculation

All the time

Often

Sometimes

Rarely

Never

70 73,0

20 15,0

10 8,02,0

2,0

0%

20%

40%

60%

80%

100%

M5 M5 + FT

Diminished Libido

All the time

Often

Sometimes

Rarely

Never

60,073,0

3017,0

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 3,03,3

0%

20%

40%

60%

80%

100%

M5 M5 + FT

Scalp Pruritus

All the time

Often

Sometimes

Rarely

Never

56,7

78,0

20,0

10,016,78,0

6,6 2

2

0%

20%

40%

60%

80%

100%

M5 M5 + FT

Body Hair Increase

All the time

Often

Sometimes

Rarely

Never

73,485

13,3

11103,0

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