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1.
J Neurosci Res ; 102(10): e25389, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39352214

RESUMO

This study aims to compare the efficacy of 5-alpha-reductase inhibitors (5ARIs) on anxiety and depression between long-term and short-term treatment followed by withdrawal in d-galactose (Dgal)-induced senescent male rats. Thirty-two, 8-week-old, male Wistar rats were divided into two groups: control rats and Dgal-treated rats (150 mg/kg/day; subcutaneously) for 18 weeks. At week 13, Dgal-treated rats were subdivided into three subgroups: (1) vehicle (DgV), (2) long-term treatment with 5ARIs, Finasteride 5 mg/kg/day, per oral for 6 weeks (DgF), (3) short-term treatment with 5ARIs, Finasteride 5 mg/kg/day, per oral for 2 weeks followed by a 4-week withdrawal period (DgW). Anxiety and depression were assessed using the elevated-plus maze (EPM) and splash test (ST). Blood was collected for biochemical analysis. After euthanasia, the brains were removed to examine brain inflammation, oxidative stress, neuroactive steroids, brain metabolites, and brain senescent markers. We found that DgV rats exhibited metabolic disturbance with a reduced preference index of the EPM, and grooming duration in ST. Increased brain neurotoxic metabolites, along with increased brain inflammation/oxidative stress, and reduced microglia complexity were observed in the DgV rats. Both therapeutic approaches improved metabolic parameters and preference index in the open arm of EPM in Dgal-treated rats, while grooming duration and microglia complexity were increased only in DgF rats. Our results indicate that Fin reduces depression-like and anxiety-like behaviors by reducing brain inflammation, oxidative stress, and brain senescent. In conclusion, long-term treatment with 5ARIs is more effective in alleviating depression than short-term treatment followed by withdrawal in Dgal-induced early senescent male rats.


Assuntos
Inibidores de 5-alfa Redutase , Envelhecimento , Ansiedade , Depressão , Finasterida , Ratos Wistar , Animais , Masculino , Finasterida/farmacologia , Ansiedade/tratamento farmacológico , Depressão/tratamento farmacológico , Ratos , Inibidores de 5-alfa Redutase/farmacologia , Envelhecimento/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Galactose/toxicidade , Comportamento Animal/efeitos dos fármacos
2.
Arch Dermatol Res ; 316(9): 622, 2024 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-39276230

RESUMO

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.


Assuntos
Alopecia , Quimioterapia Combinada , Dutasterida , Finasterida , Minoxidil , Espironolactona , Humanos , Feminino , Finasterida/administração & dosagem , Dutasterida/administração & dosagem , Espironolactona/administração & dosagem , Alopecia/tratamento farmacológico , Minoxidil/administração & dosagem , Adulto , Resultado do Tratamento , Quimioterapia Combinada/métodos , Pessoa de Meia-Idade , Inibidores de 5-alfa Redutase/administração & dosagem , Administração Oral , Cabelo/efeitos dos fármacos , Cabelo/crescimento & desenvolvimento , Adulto Jovem , Estudos Retrospectivos
3.
Am Fam Physician ; 110(3): 243-250, 2024 09.
Artigo em Inglês | MEDLINE | ID: mdl-39283847

RESUMO

More than 80 million people in the United States are affected by hair loss, also known as alopecia. Nonscarring alopecias are categorized as diffuse, patterned, or focal. Diffuse alopecias include telogen and anagen effluvium, are usually self-limited, and depend on stopping the underlying cause (e.g., stress). Patterned hair loss, specifically androgenetic alopecia, is the most common form of alopecia; it is typically genetic, and first-line treatment is minoxidil. Oral finasteride is another treatment available for male patients. Focal hair loss includes alopecia areata, which is typically self-limited and treated with intralesional corticosteroid or oral immunosuppressant therapy; tinea capitis, which is treated with oral antifungals; and traction alopecia, which is treated by decreasing tension on the hair. Hair loss can be caused by several systemic diseases. A comprehensive history and physical examination, with targeted laboratory testing, may elucidate malnutrition, autoimmune diseases, and endocrine disease. Patients with moderate to severe hair loss are more likely to have accompanying anxiety, depression, and lower work productivity and quality-of-life scores. Educating patients about expected hair changes, treatment options, and realistic outcomes can help patients feel that they are being listened to and that their hair loss is being taken seriously.


Assuntos
Alopecia , Minoxidil , Humanos , Alopecia/diagnóstico , Alopecia/terapia , Alopecia/tratamento farmacológico , Alopecia/etiologia , Minoxidil/uso terapêutico , Masculino , Finasterida/uso terapêutico , Feminino
4.
Sci Rep ; 14(1): 19164, 2024 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-39160179

RESUMO

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.


Assuntos
Doxazossina , Finasterida , Próstata , Doenças Prostáticas , Próstata/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Finasterida/farmacologia , Finasterida/uso terapêutico , Doxazossina/farmacologia , Doxazossina/uso terapêutico , Agentes Urológicos/farmacologia , Agentes Urológicos/uso terapêutico , Resistência a Medicamentos , Doenças Prostáticas/tratamento farmacológico , Humanos
5.
J Control Release ; 373: 652-666, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39089503

RESUMO

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.


Assuntos
Inibidores de 5-alfa Redutase , Alopecia , Vesículas Extracelulares , Finasterida , Ouro , Folículo Piloso , Nanopartículas Metálicas , Células-Tronco , Finasterida/administração & dosagem , Ouro/química , Ouro/administração & dosagem , Alopecia/terapia , Animais , Nanopartículas Metálicas/administração & dosagem , Células-Tronco/citologia , Inibidores de 5-alfa Redutase/administração & dosagem , Humanos , Lipossomos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Cabelo/crescimento & desenvolvimento
6.
Age Ageing ; 53(7)2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-39046116

RESUMO

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.


Assuntos
Inibidores de 5-alfa Redutase , Dutasterida , Finasterida , Degeneração Macular , Hiperplasia Prostática , Tansulosina , Humanos , Inibidores de 5-alfa Redutase/efeitos adversos , Inibidores de 5-alfa Redutase/uso terapêutico , Masculino , Idoso , Hiperplasia Prostática/tratamento farmacológico , Hiperplasia Prostática/epidemiologia , Estudos Retrospectivos , Taiwan/epidemiologia , Incidência , Degeneração Macular/epidemiologia , Degeneração Macular/diagnóstico , Degeneração Macular/induzido quimicamente , Dutasterida/uso terapêutico , Dutasterida/efeitos adversos , Tansulosina/uso terapêutico , Tansulosina/efeitos adversos , Finasterida/efeitos adversos , Finasterida/uso terapêutico , Fatores de Risco , Pessoa de Meia-Idade , Medição de Risco , Bases de Dados Factuais
7.
Behav Brain Res ; 472: 115155, 2024 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-39032869

RESUMO

Several studies have reported side effects of finasteride (FIN), such as anxiety/depression in young men. Obesity is also positively associated with anxiety/depression symptoms; however, the impacts of long-term FIN treatment and FIN withdrawal in young obese individuals are still elusive. The present study aimed to investigate the effect of long-term treatment and its withdrawal on anxiety/depression and brain pathologies in lean and obese adult male rats. Forty-eight male Wistar rats were equally divided into two groups and fed either a normal or high-fat diet. At age 13 weeks, rats in each dietary group were divided into three subgroups: 1) the control group receiving drinking water, 2) the long-term treatment group receiving FIN orally at 5 mg/kg/day for 6 weeks, and 3) the withdrawal group receiving FIN orally at 5 mg/kg/day for 2 weeks followed by a 4-week withdrawal period. Anxiety/depression-like behaviors, biochemical analysis, brain inflammation, oxidative stress, neuroactive steroids, brain metabolites, and microglial complexity were tested. The result showed that lean rats treated with long-term FIN and its withdrawal exhibited metabolic disturbances, depressive-like behavior, and both groups showed increased neurotoxic metabolites and reduced microglial complexity. Obesity itself led to metabolic disturbances and brain pathologies, including increased inflammation, oxidative stress, and quinolinic acid, as well as reduced microglial complexity, resulting in increased anxiety- and depression-like behaviors. Interestingly, the long-term FIN treatment group in obese rats showed attenuation of depressive-like behaviors, brain inflammation, and oxidative stress, along with increased brain antioxidants, suggesting the possible benefits of FIN in obese conditions.


Assuntos
Inibidores de 5-alfa Redutase , Ansiedade , Depressão , Dieta Hiperlipídica , Finasterida , Obesidade , Ratos Wistar , Animais , Masculino , Obesidade/tratamento farmacológico , Depressão/tratamento farmacológico , Depressão/etiologia , Inibidores de 5-alfa Redutase/farmacologia , Ratos , Finasterida/farmacologia , Dieta Hiperlipídica/efeitos adversos , Ansiedade/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , Comportamento Animal/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Modelos Animais de Doenças
8.
Prostate ; 84(14): 1309-1319, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39004950

RESUMO

BACKGROUND: Benign prostatic hyperplasia (BPH) is a condition generally associated with advanced age in men that can be accompanied by bothersome lower urinary tract symptoms (LUTS) including intermittency, weak stream, straining, urgency, frequency, and incomplete bladder voiding. Pharmacotherapies for LUTS/BPH include alpha-blockers, which relax prostatic and urethral smooth muscle and 5ɑ-reductase inhibitors such as finasteride, which can block conversion of testosterone to dihydrotestosterone thereby reducing prostate volume. Celecoxib is a cyclooxygenase-2 inhibitor that reduces inflammation and has shown some promise in reducing prostatic inflammation and alleviating LUTS for some men with histological BPH. However, finasteride and celecoxib can reduce mitochondrial function in some contexts, potentially impacting their efficacy for alleviating BPH-associated LUTS. METHODS: To determine the impact of these pharmacotherapies on mitochondrial function in prostate tissues, we performed immunostaining of mitochondrial Complex I (CI) protein NADH dehydrogenase [ubiquinone] iron-sulfur protein 3 (NDUFS3) and inflammatory cells on BPH specimens from patients naïve to treatment, or who were treated with celecoxib and/or finasteride for 28 days, as well as prostate tissues from male mice treated with celecoxib or vehicle control for 28 days. Quantification and statistical correlation analyses of immunostaining were performed. RESULTS: NDUFS3 immunostaining was decreased in BPH compared to normal adjacent prostate. Patients treated with celecoxib and/or finasteride had significantly decreased NDUFS3 in both BPH and normal tissues, and no change in inflammatory cell infiltration compared to untreated patients. Mice treated with celecoxib also displayed a significant decrease in NDUFS3 immunostaining and no change in inflammatory cell infiltration. CONCLUSIONS: These findings suggest that celecoxib and/or finasteride are associated with an overall decrease in NDUFS3 levels in prostate tissues but do not impact the presence of inflammatory cells, suggesting a decline in mitochondrial CI function in the absence of enhanced inflammation. Given that BPH has recently been associated with increased prostatic mitochondrial dysfunction, celecoxib and/or finasteride may exacerbate existing mitochondrial dysfunction in some BPH patients thereby potentially limiting their overall efficacy in providing metabolic stability and symptom relief.


Assuntos
Celecoxib , Finasterida , Hiperplasia Prostática , Masculino , Hiperplasia Prostática/tratamento farmacológico , Hiperplasia Prostática/metabolismo , Hiperplasia Prostática/patologia , Finasterida/farmacologia , Finasterida/uso terapêutico , Humanos , Animais , Celecoxib/farmacologia , Celecoxib/uso terapêutico , Camundongos , Inibidores de Ciclo-Oxigenase 2/farmacologia , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitocôndrias/patologia , Idoso , Próstata/efeitos dos fármacos , Próstata/patologia , Próstata/metabolismo , Inibidores de 5-alfa Redutase/farmacologia , Inibidores de 5-alfa Redutase/uso terapêutico , Transporte de Elétrons/efeitos dos fármacos , Pessoa de Meia-Idade , Proteínas Mitocondriais/metabolismo , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Sintomas do Trato Urinário Inferior/metabolismo , Sintomas do Trato Urinário Inferior/patologia , Complexo I de Transporte de Elétrons/metabolismo
9.
Facial Plast Surg Clin North Am ; 32(3): 417-423, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38936999

RESUMO

Alopecia, a widespread issue affecting both genders, often manifests as androgenetic alopecia, although a thorough examination is needed to rule out other causes. This chapter focuses on the treatment of androgenetic alopecia. Finasteride and minoxidil, the Food and Drug Administration-approved treatments, offer stability and in some cases improvement in scalp coverage. Platelet-rich plasma exhibits positive results as an off-label alopecia therapy. For eligible individuals, hair transplantation proves effective, using healthy follicular units to restore hair-bearing areas. Multiple options allow for the tailoring of interventions to each patient.


Assuntos
Alopecia , Finasterida , Minoxidil , Plasma Rico em Plaquetas , Humanos , Alopecia/terapia , Minoxidil/uso terapêutico , Finasterida/uso terapêutico , Inibidores de 5-alfa Redutase/uso terapêutico , Masculino , Feminino
11.
Ecotoxicol Environ Saf ; 281: 116606, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38896907

RESUMO

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.


Assuntos
Inibidores de 5-alfa Redutase , Daphnia , Finasterida , Metabolismo dos Lipídeos , Poluentes Químicos da Água , Animais , Finasterida/toxicidade , Daphnia/efeitos dos fármacos , Inibidores de 5-alfa Redutase/toxicidade , Poluentes Químicos da Água/toxicidade , Metabolismo dos Lipídeos/efeitos dos fármacos , Disruptores Endócrinos/toxicidade , Reprodução/efeitos dos fármacos , Lipidômica , Daphnia magna
12.
Adv Ther ; 41(7): 2936-2952, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38833144

RESUMO

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.


Assuntos
Inibidores de 5-alfa Redutase , Alopecia , Finasterida , Humanos , Finasterida/farmacocinética , Finasterida/administração & dosagem , Finasterida/efeitos adversos , Alopecia/tratamento farmacológico , Masculino , Adulto , Inibidores de 5-alfa Redutase/farmacocinética , Inibidores de 5-alfa Redutase/administração & dosagem , Inibidores de 5-alfa Redutase/efeitos adversos , Inibidores de 5-alfa Redutase/farmacologia , Di-Hidrotestosterona/farmacocinética , Di-Hidrotestosterona/administração & dosagem , Di-Hidrotestosterona/sangue , Pessoa de Meia-Idade , Preparações de Ação Retardada , Testosterona/farmacocinética , Testosterona/sangue , Injeções Subcutâneas , Adulto Jovem , Microesferas
13.
J Cosmet Laser Ther ; 26(1-4): 1-16, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38852607

RESUMO

We aimed to determine the efficacy of the various available oral, topical, and procedural treatment options for hair loss in individuals with androgenic alopecia. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the National Library of Medicine was performed. Overall, 141 unique studies met our inclusion criteria. We demonstrate that many over the counter (e.g. topical minoxidil, supplements, low-level light treatment), prescription (e.g. oral minoxidil, finasteride, dutasteride), and procedural (e.g. platelet-rich plasma, fractionated lasers, hair transplantation) treatments successfully promote hair growth, highlighting the superiority of a multifaceted and individualized approach to management.


Assuntos
Alopecia , Terapia com Luz de Baixa Intensidade , Minoxidil , Plasma Rico em Plaquetas , Humanos , Alopecia/tratamento farmacológico , Alopecia/terapia , Terapia com Luz de Baixa Intensidade/métodos , Minoxidil/uso terapêutico , Finasterida/uso terapêutico , Dutasterida/uso terapêutico
14.
J Cosmet Dermatol ; 23(10): 3287-3294, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38873787

RESUMO

BACKGROUND: Oral finasteride and topical minoxidil formulations are the only FDA-approved drug therapies for androgenetic alopecia (AGA). Research into dutasteride, topical finasteride, and nontopical minoxidil (low-dose oral and sublingual) formulations in the treatment of AGA has spiked within recent years. Early findings show that these alternative drug therapies may have similar to improved efficacy and safety profiles relative to the conventional treatment options. AIMS: Conducting a bibliometric analysis, compare trends in publications on these alternative drug therapies, identify key contributors, evaluate major findings from top-cited articles, and elucidate gaps in evidence. METHODS: A search was conducted on the Web of Science database for publications on the use of alternative drug therapies in the treatment of AGA. A total of 95 publications, published between January 2003-March 2024, and their citation metadata were included in the analysis. RESULTS: Dutasteride showed the greatest (n = 37) and longest (20+ years) history of publications, as well as the highest cumulative citations (n = 914); however, nontopical minoxidil showed a burst in research activity within the last 5 years (n = 33 publications since 2019). A relatively low number of randomized control trials (n = 3) for nontopical minoxidil suggests a need for higher-quality evidence. CONCLUSIONS: Our analysis reveals major trends, contributors, and gaps in evidence for alternative drug therapies for AGA, which can help inform researchers on their future projects in this growing field of study. There is enthusiasm for exploring off-label formulations: nontopical forms of minoxidil (oral and sublingual), topical finasteride, and mesotherapy.


Assuntos
Alopecia , Bibliometria , Dutasterida , Finasterida , Minoxidil , Alopecia/tratamento farmacológico , Humanos , Minoxidil/administração & dosagem , Minoxidil/uso terapêutico , Dutasterida/uso terapêutico , Dutasterida/administração & dosagem , Finasterida/uso terapêutico , Finasterida/administração & dosagem , Administração Oral , Ensaios Clínicos Controlados Aleatórios como Assunto , Inibidores de 5-alfa Redutase/uso terapêutico , Inibidores de 5-alfa Redutase/administração & dosagem , Administração Tópica , Resultado do Tratamento
15.
J Cosmet Dermatol ; 23(9): 2964-2972, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38725143

RESUMO

BACKGROUND: The evidence base pertaining to the efficacy of monotherapies for androgenetic alopecia (AGA), the most common form of hair loss, is ever expanding-and this warrants a formal comparison therapies' effect on a frequent basis. AIMS: The objective of the current study was to determine the comparative effect of relevant monotherapies for male AGA. PATIENTS/METHODS: Our aim was achieved by conducting Bayesian network meta-analysis (NMA), under a random effects model, for two outcomes: 6-month change in (1) total and (2) terminal hair density in adult (i.e., aged 18 years and above) men with AGA; these analyses were preceded by a systematic search of the peer-reviewed literature for suitable data. Interventions' surface under the cumulative ranking curve (SUCRA) and pairwise relative effects (quantified as mean differences) were estimated through the NMAs. RESULTS: We determined the comparative effect of 20 active comparators and a control (i.e., placebo/vehicle). "Dutasteride 0.5 mg once daily for 24 weeks" was ranked the most effective in terms of 6-month change in (1) total hair density (SUCRA = 87%) and terminal hair density (SUCRA = 98%). Our results showed that interventions' effectiveness can be dose dependent. CONCLUSIONS: Our updated analyses of the up-to-date evidence regarding monotherapies for male AGA showed that the oral form of 5-alpha reductase inhibitors are more effective than oral minoxidil and other newer agents like Botox, microneedling, and photobiomodulation. Our findings can better inform clinical decision making and design of future research studies.


Assuntos
Inibidores de 5-alfa Redutase , Alopecia , Minoxidil , Metanálise em Rede , Humanos , Masculino , Inibidores de 5-alfa Redutase/administração & dosagem , Alopecia/terapia , Teorema de Bayes , Dutasterida/administração & dosagem , Finasterida/uso terapêutico , Finasterida/administração & dosagem , Cabelo/crescimento & desenvolvimento , Cabelo/efeitos dos fármacos , Minoxidil/administração & dosagem , Resultado do Tratamento
16.
J Cosmet Dermatol ; 23(9): 2956-2963, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38713003

RESUMO

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.


Assuntos
Alopecia , Finasterida , Minoxidil , Medidas de Resultados Relatados pelo Paciente , Humanos , Finasterida/administração & dosagem , Finasterida/efeitos adversos , Masculino , Estudos Retrospectivos , Alopecia/tratamento farmacológico , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Minoxidil/administração & dosagem , Minoxidil/efeitos adversos , Administração Oral , Telemedicina , Resultado do Tratamento , Inibidores de 5-alfa Redutase/administração & dosagem , Inibidores de 5-alfa Redutase/efeitos adversos , Administração Cutânea , Autoimagem , Cabelo/efeitos dos fármacos , Quimioterapia Combinada/métodos
18.
Langmuir ; 40(20): 10551-10560, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38710593

RESUMO

Although finasteride (FNS) tablets are considered the most effective drug for the treatment of androgenetic alopecia (AGA), their clinical applications are limited due to the associated side effects including decreased libido, breast enlargement, and liver dysfunction. In this study, we have developed a personalized microneedle (PMN) with a double-layer structure that incorporates FNS-loaded microspheres (MPs) to accommodate irregular skin surfaces. This design enables the sustained release of FNS, thereby reducing potential side effects. The needle body was synthesized with high-strength hyaluronic acid (HA) as the base material substrate. The backing layer utilized methacrylate gelatin (GelMA) with specific toughness, enabling PMN to penetrate the skin while adapting to various skin environments. The length of PMN needles (10 × 10) was approximately 600 µm, with the bottom of the needles measuring about 330 µm × 330 µm. The distance between adjacent tips was around 600 µm, allowing the drug to penetrate the stratum corneum of the skin. The results of the drug release investigation indicated the sustained and regulated release of FNS from PMN, as compared to that of pure FNS and FNS-MPs. Further, the cytotoxicity assay demonstrates that PMS displays good cytocompatibility. Altogether, this mode of administration has immense potential for the development of delivery of other drugs, as well as in the medical field.


Assuntos
Administração Cutânea , Finasterida , Microesferas , Agulhas , Finasterida/administração & dosagem , Finasterida/farmacocinética , Finasterida/química , Ácido Hialurônico/química , Animais , Humanos , Sistemas de Liberação de Medicamentos , Liberação Controlada de Fármacos , Pele/metabolismo , Pele/efeitos dos fármacos
19.
Lasers Med Sci ; 39(1): 128, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38724798

RESUMO

Laser sources have established their potential effect in inducing hair regrowth. No large cohort study has evaluated the effect of ablative fractional 2940-nm erbium yttrium aluminum garnet (Er: YAG) laser in the treatment of androgenetic alopecia (AGA). To investigate the efficacy and safety of the ablative fractional 2940-nm Er: YAG laser in combination with medication therapy for the treatment of AGA. We performed a retrospective study between first July 2021 to 30th December 2021. All included patients received oral finasteride and topical minoxidil, or combined with six sessions of Er: YAG laser at 2-week intervals. Patients were divided into medication or combined therapy groups. The efficacy of the two therapies was evaluated by the investigator's Global Assessment (IGA) scores and the patient's Likert satisfaction scale at week 12 and week 24. Changes in total, terminal and villous hair count, total and terminal hair diameter, and AGA grade were also recorded. Adverse events were evaluated at each follow-up. A total of 192 male patients with AGA were included, including 67 receiving combination treatment, and 125 receiving medication treatment. At week 24, the combination treatment afforded superior outcomes in the IGA score, patient's global assessment, total and terminal hair counts, and diameters (all P<0.05). No severe adverse events were reported in both groups. The combined therapy of ablative fractional Er: YAG laser and medication was superior in treating male AGA than single medication therapy without serious adverse effects.


Assuntos
Alopecia , Lasers de Estado Sólido , Humanos , Alopecia/terapia , Alopecia/radioterapia , Lasers de Estado Sólido/uso terapêutico , Masculino , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , Resultado do Tratamento , Finasterida/administração & dosagem , Finasterida/uso terapêutico , Minoxidil/administração & dosagem , Terapia Combinada , Terapia com Luz de Baixa Intensidade/métodos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Terapia com Luz de Baixa Intensidade/instrumentação
20.
J Psychiatr Res ; 174: 304-318, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38685188

RESUMO

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.


Assuntos
Inibidores de 5-alfa Redutase , Ansiedade , Corticosterona , Depressão , Finasterida , Plasticidade Neuronal , Ratos Wistar , Animais , Masculino , Finasterida/farmacologia , Finasterida/administração & dosagem , Finasterida/efeitos adversos , Inibidores de 5-alfa Redutase/farmacologia , Inibidores de 5-alfa Redutase/administração & dosagem , Inibidores de 5-alfa Redutase/efeitos adversos , Plasticidade Neuronal/efeitos dos fármacos , Plasticidade Neuronal/fisiologia , Ansiedade/induzido quimicamente , Ansiedade/fisiopatologia , Corticosterona/sangue , Ratos , Depressão/induzido quimicamente , Depressão/tratamento farmacológico , Depressão/fisiopatologia , Modelos Animais de Doenças , Hipocampo/efeitos dos fármacos , Reconhecimento Psicológico/efeitos dos fármacos
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