Role of Dutasteride in the Treatment of Androgenetic Alopecia

L. Khondker, Pranam Swapan Dash
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Abstract

This study evaluates the role of dutasteride in the treatment of androgenetic alopecia. A prospective, open-labeled interventional study conducted at the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2023 to March 2024. Men with Androgenetic alopecia (AGA) who did not show significant improvement when treated with finasteride at a dose of 1 mg/d for at least six months were enrolled. Ninety patients were recruited after taking informed consent. Patients were treated with dutasteride at a dose of 0.5 mg daily for 24 weeks. Clinical assessment was performed by dermatologists and subjective evaluation of overall assessment was done based onchanges in the size of the vertex spot, hair loss on top of the scalp, bitemporal recession, the amount of hair shedding and hair quality on a 3-point rating scale (increased, no change, or decreased). The mean age of study patients was 36.3±12 years and majority of the patients 30(33.3%) belonged to the age group 41- 50 years with followed by 27(30.0%) in the age group 31-40 years. Regarding subjective evaluation of overall assessment, in case of change in size of vertex spot, majority 77(85.6%) showed decreased, in case of hair loss from top of scalp, majority 83(92.2%) reported decreased, in case of bitemporal recession, majority 82(91.1%) showedno change, in case of hair shedding, majority 87(96.7%) showed decreased and in case of hair quality, 85(94.4%) reported increased and no patient reported of decreased. Regarding clinical assessment of investigator that majority of the patients 40(44.5%) was moderately improved (+2), followed by 30(33.3%) was greatly improved (score of +3), 18(20.0%) was slightly improved (+1) and only 2(2.2%) was unchanged (0). Among the ninety patients of androgenetic alopecia, 3(3.3%) showed decreased libido and 2(2.2%) showed erectile dysfunction. The study concluded that dutasteride is effective and safe in the treatment of androgenetic alopecia. This study will provide the therapeutic basis for dutasteride as an alternative treatment option for patients with AGA recalcitrant to finasteride over six months. Therefore, dutasteride will become a treatment of choice for androgenetic alopecia (AGA) in near future.
度他雄胺在治疗雄激素性脱发中的作用
本研究评估了度他雄胺在治疗雄激素性脱发中的作用。这是一项前瞻性、开放标签的干预研究,于 2023 年 4 月至 2024 年 3 月在达卡班加班杜谢赫-穆吉布医科大学(BSMMU)皮肤病与性病学系进行。该研究招募了雄激素性脱发(AGA)男性患者,这些患者在接受非那雄胺治疗至少六个月(剂量为 1 毫克/天)后,病情没有明显改善。在获得知情同意后,共招募了 90 名患者。患者接受每日0.5毫克剂量的度他雄胺治疗,为期24周。由皮肤科医生进行临床评估,并根据顶点大小、头皮顶部脱发情况、颞部脱发情况、头发脱落量和头发质量的变化(增加、无变化或减少)进行主观评估。研究对象的平均年龄为(36.3±12)岁,其中 30 人(33.3%)属于 41-50 岁年龄组,27 人(30.0%)属于 31-40 岁年龄组。在对总体评估的主观评价方面,在顶点大小变化方面,大多数 77 人(85.6%)表示有所减少;在头皮顶部脱发方面,大多数 83 人(92.2%)表示有所减少;在颞部脱发方面,大多数 82 人(91.1%)表示没有变化;在头发脱落方面,大多数 87 人(96.7%)表示有所减少;在头发质量方面,85 人(94.4%)表示有所增加,没有患者表示有所减少。根据研究人员的临床评估,大多数患者有 40 人(44.5%)病情得到中度改善(+2 分),30 人(33.3%)病情得到大幅改善(+3 分),18 人(20.0%)病情得到轻微改善(+1 分),只有 2 人(2.2%)病情不变(0 分)。在 90 名雄激素性脱发患者中,3 人(3.3%)性欲减退,2 人(2.2%)出现勃起功能障碍。研究认为,度他雄胺治疗雄激素性脱发有效且安全。这项研究将为使用非那雄胺超过 6 个月仍不见效的 AGA 患者提供治疗依据,将其作为一种替代疗法。因此,在不久的将来,度他雄胺将成为治疗雄激素性脱发(AGA)的首选药物。
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