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This study investigated the effect of Urtica dioica roots etheric extract (UDEE) on oxidative stress, and urine obstruction with histopathological examinations of prostatic and renal tissues,and suggests computational methods as a complementary method, to make a hypothesis on the overall effect of UDEE in the treatment of benign prostatic hyperplasia (BPH).Gas chromatography/mass spectrometry was utilised to characterise UDEE.BPH was induced in rats through daily subcutaneous injections of testosterone propionate. Rats were also orally administered UDEE or a vehicle. After four weeks, prostate weight, urine output, and biochemical markers were evaluated. UDEE treatment demonstrated significant regression of prostatic enlargement, improved biochemical and histopathological characteristics, and regulation of antioxidant activity levels. Phytosteroids stand out, act by inhibiting 5α-reductase and aromatase. This study provides an insight into treatment of BPH, demonstrating safety of this compound towards the kidney compared to finasteride without severe side effects. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical efficacy and safety of 1 565 nm non-ablative fractional laser combined with topical minoxidil and oral finasteride in the treatment of patients with androgenetic alopecia (AGA). Methods Seventy-five male AGA patients with Norwood-Hamilton classification grade Ⅱ-Ⅲ, were randomly assigned into three groups: the control group 1, the control group 2 and the experimental group, with 25 cases in each group. Patients in the control group 1 received topical 5% minoxidil (1 mL, twice daily). Patients in the control group 2 were treated with both topical 5% minoxidil and oral finasteride (1 mg, once daily). Patients in the experimental group received a combined therapy of 1 565 nm non-ablative fractional laser in addition to topical 5% minoxidil and oral finasteride. Hair overall efficacy was evaluated using a 7-point rating scale after 24 weeks of treatment. Hair diameter and density were measured using a dermoscope. Patient satisfaction was assessed post-treatment, and adverse reactions were recorded. Results The overall efficacy of hair in the experimental group was superior to the control group 1 and the control group 2. There were no significant differences in hair density and hair diameter before treatment between the three groups (P＞0.05). After treatment, hair diameter and density increased in all three groups compared to baseline values (P＜0.05), and the hair diameter and hair density of the experimental group were higher than those of the control group 1 and the control group 2 (P＜ 0.05). Patient satisfaction in the experimental group was higher than that in the control group 1 and the control group 2 (P＜ 0.05). Patients in the experimental group experienced tolerable pain and burning sensations during laser treatment, and the symptoms were self-alleviated within a few hours. There were no serious adverse reactions reported in any group. Conclusion The combination therapy of 1 565 nm non-ablative fractional laser, 5% minoxidil, and finasteride demonstrates significantly better efficacy in the treatment of AGA than minoxidil and finasteride alone drug therapy. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA) is a non-fatal disease prevalent worldwide. However, mixed efficacy has been observed among different therapies for hair regrowth in AGA patients. Thus, a nano-platform with synergistic treatments based on a hybrid extracellular vesicle encapsulating gold nanoparticles (AuNPs) and finasteride (Hybrid/Au@Fi) was constructed through membrane fusion between hair follicle stem cell (HFSC)-derived extracellular vesicles and liposomes. These hybrid vesicles (HVs) not only fuel hair regrowth by providing cellular signals in extracellular vesicles, but also improve storage stability, follicle retention, and drug encapsulation efficiency (EE%) for finasteride inhibiting 5α-reductase, and nano-size AuNPs that simulate low-level laser therapy (LLLT) with similar photothermal effects in vitro. The EE% of finasteride in these HVs reached 45.33%. The dual administration of these extracellular vesicles and finasteride showed a strong synergistic effect on HFSCs in vitro. In an AGA mouse model, once-daily topical Hybrid/Au@Fi (115.07 ± 0.32 nm, −7.50 ± 1.68 mV) gel led to a faster transition of hair follicles (HFs) from the catagen to the anagen, increased hair regrowth coverage, and higher quality of regrowth hair, compared to once-daily 5% minoxidil treatment. Compared to topical minoxidil, the multifaceted synergistic therapy of Hybrid/Au@Fi through topical administration offers a new option for intractable AGA patients with low side effects. [Display omitted] • These hybrid vesicles improved storage stability for cargos, follicle retention, and drug encapsulation efficiency (EE%) for finasteride. • The Hybrid/Au@Fi (115.07 ± 0.32 nm, −7.50 ± 1.68 mV) facilitated simulated in vitro layered dermal papilla cell (DPC) migration and angiogenesis with favorable cell dynamic behavior and no cytotoxicity. • In an AGA mouse model, once-daily topical application of Hybrid/Au@Fi gel exhibited a faster transition of hair follicles from the catagen to the anagen, higher hair regrowth coverage, and improved quality of regrowth hair, compared to once-daily 5% minoxidil treatment. [ABSTRACT FROM AUTHOR]

Background: Oral finasteride and topical minoxidil are the current standard of care for male androgenetic alopecia and a combination of the two treatments can be considered for greater efficacy. Clinical trials of topical finasteride have also yielded promising results, but routine care data are lacking. Aims: To examine patient‐reported outcomes of men with androgenetic alopecia who received topical finasteride admixed with minoxidil compared to the current standard of care (oral finasteride). Methods: Retrospective, cross‐sectional study with data from a German direct‐to‐consumer teledermatology platform between December 2021 and January 2023. Patient‐reported outcomes were collected through voluntary follow‐up questionnaires provided after 6 weeks on topical finasteride/minoxidil or oral finasteride treatment. Results: A total of 1545 patients who received topical finasteride/minoxidil treatment were included; 238 (15.4%) participated in the follow‐up questionnaire. At week six, 62.2% (148/238) reported positive changes in their hair appearance, and 44.1% (105/238) reported an improvement of self‐esteem. Treatment‐related adverse events were reported in 11.8% (28/238). Full treatment adherence was observed in 74.4% (177/238). Comparing the topical treatment group to those receiving oral finasteride, lower treatment adherence was reported, along with higher rates of local adverse events; no difference was found in the incidence of sexual adverse events. Conclusion: Based on patient‐reported outcomes, topical finasteride/minoxidil seems to be effective and well tolerated, but not superior to oral finasteride. Lower treatment adherence for topical usage must be considered when considering treatment options. Additional real‐world data are needed to further evaluate the efficacy and safety of topical finasteride/minoxidil. [ABSTRACT FROM AUTHOR]

Abstract Background Based on our observations at the largest outpatient urology clinic in Iran, patients for whom finasteride is prescribed as a secondary drug to tamsulosin tend to experience earlier and more severe sexual side effects without any difference in the amelioration of symptoms. This study aimed to compare the time lag, efficacy, and side effects of combination therapy with varying doses of dutasteride or finasteride added to tamsulosin for benign prostatic hyperplasia (BPH) treatment. Methods In this study 165 were randomized into 5 groups (each N = 33); receiving tamsulosin 0.4mg plus either of A: finasteride 3mg, B: placebo, C: dutasteride 0.25mg, D: finasteride 5mg or E: dutasteride 0.5mg. During the 6-month period of the study, International Prostate Symptom Score (IPSS), post-void residual urine (PVR), International Index of Erectile Function (IIEF-5), prostate volume (PV), prostate specific antigen (PSA) and maximum urinary flow rate (Qmax) were evaluated at baseline and at the 1st, 3rd and 6th month. The differences between each time point and baseline were then compared between groups. Results At 3-month follow-up, group E exhibited a higher decrease in PSA but a greater increase in Qmax compared to group A (p = 0.047 and 0.006, respectively). Group C showed higher Qmax increase compared to group A at 3 and 6 months (p = 0.003 and 0.014) and concurrently a more pronounced PV decrease at 1 and 3 months (p = 0.047 and 0.003, respectively). Group D had a significantly more decrease in their IIEF-5 compared to group A at one-month visit (p = 0.006). Conclusions In summary, at the sixth-month follow-up, dutasteride demonstrated superiority over finasteride solely in enhancing Qmax. Therefore, dutasteride may be marginally more beneficial as a secondary component of combination therapy in BPH. Trial registration IRCT, IRCT20120516009772N2. Registered 18 January 2021 Retrospectively registered, https://irct.behdasht.gov.ir/search/result?query=IRCT20120516009772N2 .

Background: The most widespread conditions that affected on primarily male population is Benign hyperplasia of the prostate BPH. Flax seeds has been reported to antiproliferation properties and exhibit antitumor. Aim: We assessed the impact of Flax seeds ethanolic excerpt on BPH within testosterone propionate induced model of rats. Methods: A pre-3-week daily injection of testosterone propionate (3 mg/kg BW) was used to induce BPH. Twenty male rats (200-240 gm) were randomly divided to 4 equal groups (n=5) negative Group under control was given PBS orally, corn oil S/C, BPH induced rats received 3mg/kg BW TP for 3 weeks, extract group received 50 mg/Kg extract twice daily for 2 weeks Finasteride group received standard drug 10 mg/Kg BW for 2 weeks. When the course of treatment is over, rats were sacrificed and the blood was collected and separated, the prostate of the rats were harvested for histological examination. Results: The results showed that flax seeds ethanolic extract could significantly (P [Open Vet J 2024; 14(8.000): 1928-1935]

Abstract Benign prostatic hyperplasia (BPH) may decrease patient quality of life and often leads to acute urinary retention and surgical intervention. While effective treatments are available, many BPH patients do not respond or develop resistance to treatment. To understand molecular determinants of clinical symptom persistence after initiating BPH treatment, we investigated gene expression profiles before and after treatments in the prostate transitional zone of 108 participants in the Medical Therapy of Prostatic Symptoms (MTOPS) Trial. Unsupervised clustering revealed molecular subgroups characterized by expression changes in a large set of genes associated with resistance to finasteride, a 5α-reductase inhibitor. Pathway analyses within this gene cluster found finasteride administration induced changes in fatty acid metabolism, amino acid metabolism, immune response, steroid hormone metabolism, and kinase activity within the transitional zone. We found that patients without this transcriptional response were highly likely to develop clinical progression, which is expected in 13.2% of finasteride-treated patients. Importantly, a patient’s transcriptional response to finasteride was associated with their pre-treatment kinase expression. Further, we identified novel expression signatures of finasteride resistance among the transcriptionally responded patients. These patients showed different gene expression profiles at baseline and increased prostate transitional zone volume compared to the patients who responded to the treatment. Our work suggests molecular mechanisms of clinical resistance to finasteride treatment that could be potentially helpful for personalized BPH treatment as well as new drug development to increase patient drug response.

Purpose: Benign prostate hyperplasia (BPH) is a common age-related chronic condition. Its pathogenesis involves androgen imbalance, inflammation, oxidative stress, and endoplasmic reticulum (ER) stress. This study aims to assess the protective effect of finasteride, a 5α-reductase inhibitor, against testosterone propionate (TP)-induced BPH in rats and explore its potential mechanism of action. Materials and Methods: TP-induced BPH rats received either saline or finasteride (1 mg/kg) orally once a day for 7 weeks. Prior to sacrificing the animals, blood samples were collected. After sacrifice, prostate and tissue around the prostate were dissected from seminal vesical for further analysis. Body weight, prostate weight, dihydrotestosterone (DHT), 5α-reductase type 2 (5-AR2), and prostate-specific antigen (PSA) levels were measured. In addition, HIF-1α, VEGF, MMP-2 expressions in prostate, oxidative stress, inflammation, and ER stress responses were analyzed to understand the mechanism of action of finasteride. Results: Finasteride administration inhibited prostate enlargement, DHT, 5-AR2, and PSA levels in BPH rats. Additionally, finasteride inhibited angiogenesis markers such as HIF-1α, VEGF, and MMP-2. Moreover, components of oxidative stress, inflammation, and ER stress responses were significantly regulated by finasteride treatment. Conclusions: This study suggests that finasteride prevents BPH-associated symptoms by regulating angiogenesis, reactive oxygen species, ER stress responses, and inflammation, another mechanism to explain the effect of the 5α-reductase against BPH.

Background: The most widespread condition that affected on primarily the male population is Benign hyperplasia of the prostate benign prostatic hyper-plasia (BPH). Flax seeds have been reported to have antiproliferation properties and exhibit antitumor. Aim: We assessed the impact of flax seeds ethanolic excerpt on BPH within a testosterone propionate (TP)-induced model of rats. Methods: A pre-3-week daily injection of TP (3 mg/kg BW) was used to induce BPH. Twenty male rats (200–240 gm) were randomly divided into 4 equal groups (n = 5) negative Group under control was given PBS orally, corn oil S/C, BPH-induced rats received 3 mg/kg BW TP for 3 weeks, extract group received 50 mg/Kg extract twice daily for 2 weeks Finasteride group received standard drug 10 mg/Kg BW for 2 weeks. When the course of treatment is over, rats were sacrificed and the blood was collected and separated, the prostate of the rats was harvested for histological examination. Results: The results showed that flax seeds ethanolic extract could significantly (p < 0.05) reduce the prostate gland weight, prostate index, serum level of PAS, testosterone, and 5-a reductase enzyme in BPH-induced rats and improve the tissue morphology of the prostate. Conclusion: Based on our results, the extract suggested that have a promising role in the treatment of benign hyperplasia of the prostate. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of Angelica gigas Nakai ethanol extract (AGNEX) on benign prostatic hyperplasia (BPH) models induced by castration and testosterone propionate (TP) injection. Methods: 30 rats were randomly divided into six groups of five rats each. One group was used as a normal control (CON) and the other groups were castrated and injected intraperitoneally with TP to induce BPH. Positive control group (PCON) was administered finasteride (5 mg/kg) for 4 weeks and BPH-induced group without treatment was used as negative control (NCON). Groups administered AGNEX (1.25 mg/kg (AG1.25), 5 mg/kg (AG5), or 10 mg/kg (AG10)) instead of finasteride were assigned as study groups. The complete blood cell and lipid profiles, liver and kidney function assays, serum 5α-reductase activity and DHT levels as well as the histological examination of prostate tissues were determined. Results: The prostate volume of AG10 group decreased by approximately 35 % compared to BPH induced group (NCON). The prostate weight ratio decreased by 10 % in BPH + finasteride group compared to NCON group, and by 24 and 22 % in the AG5 and AG10 groups, respectively. AG10 group exhibited the lowest levels of 5α-reductase and dihydrotestosterone. Histopathological observations of prostate tissue showed normal cell shapes and reduced intraluminal polyp formation in the control and AGNEX-administered groups. Conclusion: The administration of 10 mg/kg of AGNEX is optimal dose for protective effect against BPH. Therefore, AGNEX has potentials for further investigations as source of lead agents for BPH management. [ABSTRACT FROM AUTHOR]

This prospective, experimental study aims to evaluate the association between administration of α-blocker, 5α-reductase inhibitor, or anxiolytic medications and intraoperative floppy iris syndrome (IFIS) using a rabbit animal model. A total of 31 Metis rabbits were distributed into four groups as follows: 10 rabbits given tamsulosin, 10 rabbits given finasteride, 5 rabbits who received lorazepam, and 6 treatment-naive animals in the control group. Dosing was calculated according to body surface area ratio of man to rabbit, with a dosing duration of 43 days for all groups. Phacoemulsification maneuvers were performed by a single surgeon, who was blinded to group allocation. Any intraoperative billowing of the iris was noted and subsequently graded from 0 to 3. Higher incidences of iris billowing were found in the tamsulosin-dosed animals [OR = 8.33 (CI 95% 0.63–110.09)], (p = 0.13), the finasteride group [OR = 11.6 (CI 95% 0.92–147.6)], (p = 0.11), and the lorazepam group [OR = 7.5 (CI 95% 0.45–122.8)], (p = 0.24), as opposed to the control. Administration of α-blocker tamsulosin, 5α-reductase inhibitor finasteride, or anxiolytic medication lorazepam induces altered intraoperative iris behavior. These results correspond with previous studies and further solidify the hypothesis that systemic medication, administered both long and short-term, influences surgical parameters in cataract surgery. The present study can become the basis for further clinical or experimental research. [ABSTRACT FROM AUTHOR]

The direct and indirect electrochemical behavior of finasteride was studied using a differential pulse technique coupled with a three-electrode detection system consisting of 2 mm diameter glassy carbon as a working electrode, 2 mm diameter platinum wire as an auxiliary electrode, and silver/silver chloride saturated potassium chloride as reference electrode (Ag/AgCl sat KCl). The finasteride gives a weak reduction peak at -0.68 V. The calibration curve of finasteride was constructed using Briton-Robinson buffer solution (pH = 3), the plot of reduction peak current and concentration gives a linear relationship within the concentration range of 0.999×10-5-19.607×10-5 M, with a correlation coefficient of 0.9903. To increase the sensitivity of the method, an indirect determination of finasteride through its interaction with cupric ion was investigated in acetate buffer solution (pH=2) and followed the decrease in reduction peak current of cupric ion as a result of adding sequence addition of finasteride solution. The calibration curve for finasteride was also constructed for its interaction with cupric ions by measuring the decrease of cupric reduction peak current with the sequence additions of finasteride. The calibration curve was linear within the concentration range of 4.997×10-6-476.191×10-6 M, with a correlation coefficient of 0.9930. The binding constant (K) and the Thermodynamic parameters (ΔG, ΔH, and ΔS) for Cu2+-finasteride interaction were calculated. The suggested method was successfully applied for the determination of finasteride in tablets. [ABSTRACT FROM AUTHOR]

Background Recent studies suggest that 5α-reductase inhibitors (5ARIs) for benign prostate hyperplasia (BPH) result in abnormal retinal anatomical alteration. Objective To compare age-related macular degeneration (AMD) incidence in BPH patients receiving 5ARIs or tamsulosin. Design Retrospective, population-based cohort study using new-user and active-comparator design. Setting General population. Subjects Males with BPH, newly receiving 5ARIs or tamsulosin from 2010 to 2018. Methods Data were extracted from Taiwan's National Health Insurance Research Database. We used Cox proportional hazards model with 1:4 propensity score (PS) matching, based on intention-to-treat analysis to determine the risk of incident AMD. Sensitivity analyses included an as-treated approach and weighting-based PS methods. We also separately reported the risks of incident AMD in patients receiving finasteride and dutasteride to determine risk differences among different 5ARIs. Results We included 13 586 5ARIs users (mean age: 69 years) and 54 344 tamsulosin users (mean age: 68.37 years). After a mean follow-up of 3.7 years, no differences were observed in the risk of incident AMD between 5ARIs and tamsulosin users [hazard ratio (HR): 1.06; 95% confidence intervals (95% CI): 0.98–1.15], with similar results from sensitivity analyses. However, increased risk of incident age-related macular degeneration was observed in patients receiving dutasteride [HR: 1.13; 95% CI: 1.02–1.25], but not in those receiving finasteride [HR: 0.99; 95% CI: 0.87–1.12], in the subgroup analyses. Conclusions We found no difference between 5ARIs and tamsulosin regarding the incidence of AMD in BPH patients. However, the risk profiles for AMD differed slightly between dutasteride and finasteride, suggesting that the potency of androgen inhibition is a factor related to AMD incidence. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia is the most common type of hair loss. Although the exact cause of this condition is not fully understood, it is known to involve excessive amounts of dihydrotestosterone. There are various treatment options available for androgenetic alopecia that aim to target these mechanisms. The FDA-approved therapies for this condition include topical minoxidil, oral finasteride, and low-level light therapy. This review will discuss the potential benefits of using spironolactone, dutasteride, and bicalutamide as alternative treatment options for androgenetic alopecia. [ABSTRACT FROM AUTHOR]

Introduction: Hair loss is driven by multiple factors, including genetics. Androgenetic alopecia (AGA) is a condition in which treatments necessitate prolonged compliance with prescribed medications. We have developed IVL3001, a long-acting injectable (LAI) formulation of finasteride encapsulated within poly lactic-co-glycolic acid microspheres, to enhance the efficacy of the finasteride and to achieve consistent positive outcomes in adults. An open-label, sequential, single-dose phase I clinical trial was designed to evaluate the safety, pharmacokinetic (PK), and pharmacodynamic (PD) of IVL3001. Methods: A total of 40 non-smoking, healthy adult males were divided into three cohorts where the IVL3001 group received a single subcutaneous injection of 12–36 mg IVL3001 and 1 mg finasteride (Propecia®) once daily for 28 days. The plasma concentrations of finasteride, dihydrotestosterone (DHT), and testosterone were measured using liquid chromatography–tandem mass spectrometry. The tolerability of the injections was assessed, and compartment models were developed to predict the effective dose and assess PK/PD profiles. Results: IVL3001 and finasteride 1 mg tablets were well tolerated. IVL3001 showed consistent plasma concentrations without bursts or fluctuations. Consistent with its mechanism of action, IVL3001 reduced DHT levels. Simulation data showed that the administration of 12–36 mg of IVL3001 every 4 weeks achieved plasma concentrations similar to finasteride, with comparable DHT reduction. Conclusion: The present study represents the first clinical trial to evaluate the safety, pharmacokinetic (PK), pharmacodynamic (PD), and tolerability of finasteride long-acting injectables (LAI) in adults. The rapid onset of action sustained effective drug concentration and the prolonged half-life of IVL3001 suggest that it offers multiple benefits over conventional oral formulations in terms of therapeutic response and compliance. Trial Registration: ClinicalTrials.gov identifier, NCT04945226. [ABSTRACT FROM AUTHOR]

The most common type of alopecia in women is female androgenetic alopecia (FAGA), characterized by progressive hair loss in a patterned distribution. Many oral therapies, including spironolactone (an aldosterone antagonist), androgen receptor blockers (e.g., flutamide/bicalutamide), 5-alpha-reductase inhibitors (e.g., finasteride/dutasteride), and oral contraceptives, target the mechanism of androgen conversion and binding to its respective receptor and therefore could be administered for the treatment of FAGA. Despite significant advances in the oral treatment of FAGA, its management in patients with a history of gynecological malignancies, the most common cancers in women worldwide, may still be a concern. In this review, we focus on the safety of antiandrogens for the treatment of FAGA patients. For this purpose, a targeted literature review was conducted on PubMed, utilizing the relevant search terms. To sum up, spironolactone seems to be safe for the systemic treatment of FAGA, even in high-risk populations. However, a general uncertainty remains regarding the safety of other medications in patients with a history of gynecologic malignancies, and further studies are needed to evaluate their long-term safety in patients with FAGA and risk factors to establish an optimal risk assessment and treatment selection protocol. [ABSTRACT FROM AUTHOR]

Finasteride, a 5α-Reductase inhibitor, is used to treat male pattern baldness and benign prostatic hyperplasia. Several clinical studies show that chronic finasteride treatment induces persistent depression, suicidal thoughts and cognitive impairment and these symptoms are persistent even after its withdrawal. Previous results from our lab showed that repeated administration of finasteride for six days induces depression-like behavior. However, whether short-term finasteride administration induces anxiety-like behavior and memory impairment and alters synaptic plasticity are not known, which formed the basis of this study. Finasteride was administered to 2–2.5 months old male Wistar rats for six days and subjected to behavioral evaluation, biochemical estimation and synaptic plasticity assessment. Anxiety-like behavior was evaluated in the elevated plus maze (EPM), open field test (OFT), light/dark test (LDT), and novelty suppressed feeding test (NSFT), and learning and memory using novel object recognition test (NORT) and novel object location test (NOLT) and depression-like behavior in the sucrose preference test (SPT). Synaptic plasticity in the hippocampal Schaffer collateral-CA1 was evaluated using slice field potential recordings. Plasma corticosterone levels were estimated using ELISA. Finasteride administration induced anxiety-like behavior in the EPM, OFT, LDT and NSFT, and depression-like behavior in the SPT. Further, finasteride induced hippocampal dependent spatial learning and memory impairment in the NOLT. In addition, finasteride decreased basal synaptic plasticity and long-term potentiation (LTP) in the hippocampus. A trend of increased plasma corticosterone levels was observed following repeated finasteride administration. These results indicate the potential role of corticosterone and synaptic plasticity in finasteride-induced effects and further studies will pave way for the development of novel neurosteroid-based therapeutics in neuropsychiatric diseases. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin condition that typically develops in adults but can rarely affect adolescents and prepubertal children. In paediatric cases, topical antibiotics and antiseptic washes are first-line therapies, based on expert consensus, with more severe and/or recalcitrant cases generally needing systemic antibiotics or hormonal therapies. Biologics demonstrated efficacy in randomised controlled trials (RCTs) in adults, with adalimumab approved in patients aged 12 years and above; adult studies in interleukin inhibitors are in progress. The efficacy of biologics needs to be balanced against their cost and generally subcutaneous routes of administration. RCTs that include paediatric patients are needed in HS. [ABSTRACT FROM AUTHOR]

LDOM has enhanced treatment options for female AGA, yet its combined efficacy with therapies such as spironolactone, finasteride, or dutasteride remains inadequately explored. This study aims to compare the efficacy and safety of LDOM in combination with spironolactone versus LDOM with finasteride or dutasteride in women with AGA. Our analysis revealed that both combination therapies produced similar improvements in hair growth and had comparable safety profiles. Although the LDOM with finasteride/dutasteride group showed a greater average increase in hair width and density, these differences were not statistically significant. These results endorse the use of LDOM in combination with either spironolactone or finasteride/dutasteride for female AGA, and underscore the necessity for further research to validate these findings and assess long-term treatment outcomes. [ABSTRACT FROM AUTHOR]

We report a case of persistent gynecomastia in a healthy 20-year-old man after 1 month of low-dose finasteride. Finasteride was discontinued after 2 months, and gynecomastia was unchanged 5 months after drug withdrawal. The gynecomastia regressed but did not resolve after 6 months of treatment with raloxifene, a selective estrogen receptor modulator. One year later, bilateral mammoplasty was performed to remove the remaining breast tissue. Finasteride, a 5-alpha-reductase inhibitor, is widely used for the treatment of androgenetic alopecia. Gynecomastia is an expected side effect of this therapy given its mechanism of action. However, only 8 cases of gynecomastia have been reported with low-dose (1 mg daily) finasteride treatment since its approval for androgenetic alopecia in 1997. This raises the concern that gynecomastia resulting from low-dose finasteride is significantly underreported, causing inadequately informed patients. Further, because of the risk of gynecomastia, it is important for prescribing physicians to counsel patients regarding this complication and to consider early intervention when finasteride-induced gynecomastia first arises to prevent fibrosis and thus irreversible gynecomastia. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA) presents a significant challenge in clinical practice due to its prevalence and impact on patients’ quality of life. With a diverse array of available treatment options, selecting the most appropriate therapy demands careful consideration of factors such as efficacy, safety, practicality, and cost. This review aims to evaluate the efficacy and safety profiles of various topical treatments for AGA, investigating their potential advantages in limiting systemic side effects compared to oral medications. This article explores the pharmacology, mechanisms of action, clinical efficacy, and adverse events associated with topical medications like minoxidil, finasteride, ketoconazole shampoo, clascoterone, latanoprost, spironolactone, flutamide, cetirizine, pyrilutamide, and GT20029. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia is a common type of hair loss, which is generally influenced by genetic factors and systemic androgens resulting in follicular miniaturization. It can cause cosmetic problems leading to psychological distress among affected men and women. Effective standard medical treatments available are topical minoxidil 2 to 5%, oral finasteride, oral dutasteride, and hair transplantation. However, some patients do not achieve favorable results with standard treatments. For these reasons, other novel treatments have been developed, including new medications, regenerative medicines (autologous platelet-rich plasma, adipose-derived stem cells, micrograft generation, and exosome), and low-level laser therapy [ABSTRACT FROM AUTHOR]

Finasteride is commonly used for androgenetic alopecia (AGA) treatment. The aim of this study was to assess the therapeutic maintenance effect of a finasteride every other month (EOM) regimen and analyze clinical and laboratory differences in patients with AGA according to their treatment response. One hundred males with AGA who received finasteride 1 mg daily treatment for a year were enrolled in the study. At 1 year follow‐up, treatment responses of patients who completed the visit schedule were assessed using five scales. The patients were assigned to good or bad response groups according to their assessment. Further, they were randomly divided into two groups (daily vs. EOM) and treated with finasteride (1 mg) for 1 more year. At 2 years follow‐up, treatment efficacy was assessed. At 1‐year follow‐up, 36 patients completed the schedule, including eight and three patients in the good and bad response groups, respectively. At the 2‐year follow‐up, 23 patients completed the schedule, with nine in the daily group and 14 in the EOM group. Changes in global photographic assessment in the second year were 1.33 and 1.29 for the daily and EOM groups, respectively. The daily group showed an elevated hair density and lower concentration of dihydrotestosterone (DHT) and the DHT to testosterone ratio (DHT/T). However, the EOM group showed decreased hair density and elevated DHT and DHT/T. Following treatment response assessment after 1 year of treatment, the good response group showed early onset which was associated with maternal AGA. Analysis of serum androgen hormone magnitude of DHT reduction was much greater (54.4% vs. 44.4%). DHT/T was higher in the bad response group (1.98 vs. 2.33). We concluded that the finasteride EOM regimen showed similar maintenance effects to the daily regimen. [ABSTRACT FROM AUTHOR]

Finasteride, a steroid 5-alpha reductase inhibitor, is commonly used for the treatment of benign prostatic hyperplasia and hair loss. However, despite continued use, its environmental implications have not been thoroughly investigated. Thus, we investigated the acute and chronic adverse impacts of finasteride on Daphnia magna, a crucial planktonic crustacean in freshwater ecosystems selected as bioindicator organism for understanding the ecotoxicological effects. Chronic exposure (for 23 days) to finasteride negatively affected development and reproduction, leading to reduced fecundity, delayed first brood, reduced growth, and reduced neonate size. Additionally, acute exposure (< 24 h) caused decreased expression levels of genes crucial for reproduction and development, especially EcR-A/B (ecdysone receptors), Jhe (juvenile hormone esterase), and Vtg2 (vitellogenin), with oxidative stress-related genes. Untargeted lipidomics/metabolomic analyses revealed lipidomic alteration, including 19 upregulated and 4 downregulated enriched lipid ontology categories, and confirmed downregulation of metabolites. Pathway analysis implicated significant effects on metabolic pathways, including the pentose phosphate pathway, histidine metabolism, beta-alanine metabolism, as well as alanine, aspartate, and glutamate metabolism. This comprehensive study unravels the intricate molecular and metabolic responses of D. magna to finasteride exposure, underscoring the multifaceted impacts of this anti-androgenic compound on a keystone species of freshwater ecosystems. The findings emphasize the importance of understanding the environmental repercussions of widely used pharmaceuticals to protect biodiversity in aquatic ecosystems.

Men who report persistent sexual, neurological, and psychological side‐effects after discontinuing finasteride are said to have post‐finasteride syndrome. It is uncommon, but difficult for men suffering its effects. Although controversial, with no proven treatments, the syndrome should not be ignored. [ABSTRACT FROM AUTHOR]

Hair loss (HL), scientifically known as alopecia, is a prevalent condition affecting individuals globally. Its multifactorial origins encompass genetics, hormonal fluctuations, stress, aging, medical conditions, and medications. The psychological impact of HL on self-esteem, confidence, and overall quality of life has driven the pursuit of effective treatments to rejuvenate hair growth and appearance. Among these treatments, finasteride (FIN) has been employed to address male pattern HL, the most prevalent form of HL in men. This medication hinders the conversion of testosterone to dihydrotestosterone (DHT), a hormone that contributes to hair follicle shrinkage and cessation of hair production. While oral FIN has been widely explored, it entails undesirable side effects and varying effectiveness. This review delves into the role of FIN topical applications as a novel approach for HL treatment.

Androgenetic alopecia (AGA) is the most common nonscarring alopecia and is characterised by distinct gradual patterned hair loss. AGA is mediated by genetic predisposition and excessive follicular sensitivity to androgens, mainly in males, leading to the progressive conversion of scalp terminal hair into vellus hair. Although highly prevalent, it is not fatal but may have a severe psychosocial impact, especially on females and younger males. Significant advances have been made in understanding AGA's epidemiology and pathophysiology, but only 2 drugs remain approved by the FDA - finasteride and minoxidil. Prolonged use of these drugs, is a prerequisite for enhanced treatment response. However, this leads to poor medication adherence and adverse effects from extended use eg, the “postfinasteride syndrome” which persists beyond stopping the drug. Hence, there is a need for research on more effective alternative treatments for AGA, with fewer side effects.This paper reviewed recent advances in AGA pathophysiology and its treatment options. The recently characterized structure of type 2, 5-alpha reductase holds significance in comprehending present and prospective treatments of AGA.