Female-pattern hair loss: therapeutic update

Abstract Female androgenetic alopecia or female-pattern hair loss (FPHL) is highly prevalent and has a great impact on the quality of life. The treatment is a routine challenge in dermatological practice, as many therapeutic options have a limited level of evidence and often do not meet patients expectations. Lack of knowledge of the pathogenesis of the hair miniaturization process and the factors that regulate follicular morphogenesis restricts the prospect of innovative therapies. There is also a lack of randomized, controlled studies with longitudinal follow-up, using objective outcomes and exploring the performance of the available treatments and their combinations. Topical minoxidil, which has been used to treat female pattern hair loss since the 1990s, is the only medication that has a high level of evidence and remains the first choice. However, about 40% of patients do not show improvement with this treatment. In this article, the authors critically discuss the main clinical and surgical therapeutic alternatives for FPHL, as well as present camouflage methods that can be used in more extensive or unresponsive cases.

Unscrewing the DHT-Blocking Properties of Allium cepa Extract: Virtual Screening of Active Compounds Against 5-Alpha Reductase and Evaluation of ADME/T Properties of Compounds

Androgenetic alopecia (AGA) occurs in genetically prone men and women and is defined by pattern-related, non-scarring hair follicle shrinkage. It is estimated that up to 80% of men and 50% of women will be affected by AGA at some stage in their lives. The underlying pathophysiology may be traced back to the enzyme 5-alpha-reductase, which is responsible for the conversion of testosterone to dihydrotestosterone (DHT), a more powerful androgen, and its accumulation in hair follicles leads to hair loss. The therapeutic approach for treating AGA mainly relies on the inhibition of 5-alpha- reductase. Allium cepa (onion) extract is in trend as a natural remedy for the treatment of AGA. The study aims at in-silico and ADME/T analysis of active compounds present in onion extract against 5-alpha-reductase to evaluate and visualize protein-ligand interaction.

Fatores de risco correlacionados à alopecia frontal fibrosante em Criciúma, Santa Catarina: estudo caso-controle / Risk factors correlated with frontal fibrosing alopecia in Criciuma, Santa Catarina: case-control study

Introdução: A alopecia frontal fibrosante (AFF) é uma forma de alopecia cicatricial, em que os pacientes apresentam perda irreversível dos folículos pilosos, principalmente em região frontal e tempoparietal. Sua etiopatogenia não está totalmente elucidada, embora hipóteses sobre fatores genéticos, hormonais e comportamentais, como o uso de filtro solar e hidratante facial, já tenham sido descritas. Métodos: estudo de caso-controle, realizado com aplicação de um questionário objetivo com 33 perguntas. Foram avaliadas 60 pacientes do sexo feminino, 30 diagnosticadas com AFF e 30 não acometidas pela doença. Resultados: a média de idade da amostra foi de 64 anos (± 10,37 para casos e ± 9,40 para os controles). 76,7% das pacientes com AFF e 23,3% dos controles faziam uso de filtro solar, sendo a diferença estatisticamente significativa (p<0,001). Além disso, o uso de hidratante facial mostrou-se significativamente maior nas pacientes com alopecia (63,3%) quando comparadas aos controles (33,3%; p=0,038). Notou-se a frequência de uso de sabonete comum na face significativamente menor nas pacientes com AFF (46,7%), quando comparada ao grupo controle (83,3%; p=0,006). Conclusão: nossos resultados sugerem uma possível associação entre AFF e uso de produtos faciais, como filtro solar e hidratante. Todas as pacientes eram menopausadas, reforçando a relação hormonal com a doença

Introduction: Fibrosing Frontal Alopecia (FFA) is a form of scarring alopecia, in which patients have an irreversible loss of hair follicles, especially in the frontal and temporoparietal regions. The etiopathogenesis is not fully understood, although hypotheses about genetic, hormonal, and behavioral factors, such as the use of sunscreen and facial moisturizers, have already been described. Methods: A case-control study was conducted using an objective questionnaire with 33 questions. Sixty women were evaluated, 30 diagnosed with FFA, and 30 not affected by the disease. Results: The mean age of the sample was 64 years old. 76.7% of patients with FFA and 23.3% of controls used facial sunscreen and the difference was statistically significant (p<0.001). Also, the use of facial moisturizer was significantly higher in patients with alopecia (63.3%) when compared to controls (33.3%; p=0.038). The frequency of use of regular soap on the face was significantly lower in patients with FFA (46.7%) when compared to the control group (83.3%; p=0.006). Conclusion: Results suggest a possible association between FFA and the use of facial products, such as sunscreen and moisturizer, in this population. All patients were menopausal, reinforcing the hormonal relationship with the disease.

Vulnerabilidade de pacientes com hiperplasia prostática tratados com dutasterida e finasterida / Vulnerability of patients with prostatic hyperplasia treated with dutasteride and finasteride / Vulnerabilidad de pacientes con hiperplasia prostática tratados con dutasterida y finasterida

Resumo A hiperplasia prostática benigna é uma patologia cuja incidência vem crescendo muito nos últimos anos, em todo o Brasil. A doença está correlacionada a fatores hormonais, e o tratamento farmacológico pode gerar efeitos adversos nos pacientes. O objetivo deste estudo é avaliar fatores socioeconômicos e socioculturais que interferem na cura ou reduzem a qualidade de vida. Analisamos dados de plataformas do Governo Federal entre janeiro de 2009 a setembro de 2019, observando fatores como etnia, nível de escolaridade e situação econômica dos pacientes. Em todas as regiões do Brasil esses fatores se mostraram importantes, pois podem afetar diretamente a incidência da doença e a adesão e continuidade do tratamento.

Summary Benign prostatic hyperplasia is a pathology whose incidence has been increasing in recent years throughout Brazil. The disease is correlated with hormonal factors, and pharmacological treatment can have adverse effects on patients. This study assesses the socioeconomic and socio-cultural factors that interfere with healing or reduce quality of life. We analyzed data from Federal Government platforms between January 2009 and September 2019, looking at factors such as ethnicity, education level and economic status of patients. In all regions of Brazil, these factors proved to be important, as they can directly affect the incidence of the disease and adherence and continuity of treatment.

Resumen La hiperplasia prostática benigna es una patología cuya incidencia ha ido creciendo mucho en los últimos años, en todo Brasil. La enfermedad se correlaciona con factores hormonales, y el tratamiento farmacológico puede generar efectos adversos en los pacientes. El objetivo de este estudio es evaluar factores socioeconómicos y socioculturales que interfieren con la curación o reducen la calidad de vida. Analizamos datos de plataformas del Gobierno Federal entre enero de 2009 y septiembre de 2019, observando factores como el origen étnico, el nivel educativo y la situación económica de los pacientes. En todas las regiones de Brasil, estos factores demostraron ser importantes, ya que pueden afectar directamente la incidencia de la enfermedad y la adherencia y continuidad del tratamiento.

Does treatment with dutasteride or finasteride has impact on renal morphology? Experimental study

ABSTRACT Purpose: To investigate whether renal modifications occur following treatment with dutasteride or finasteride. Methods: Twenty-four male rats were divided into three groups: control (that received distilled water), dutasteride (0.5 mg/kg/day), and finasteride (5 mg/kg/day) groups. All administrations were given by gavage for 40 consecutive days. After inducing euthanasia, blood was collected for urea and creatinine analyses, and both the kidneys were collected for stereological analyses of kidney morphology. Results: Serum urea and creatinine levels were increased in both the finasteride and the dutasteride groups compared with those in the control group. In addition, kidney weight, kidney volume, cortical volume, glomerular volumetric density, and mean glomerular volume were reduced in both treatment groups. Finally, the number of glomeruli per kidney was reduced by 26.8% in the finasteride group and by 51.6% in the dutasteride group compared with that in the control group. Conclusions: The 5-ARIs finasteride and dutasteride promoted morphological and functional damages in rat kidneys. In addition, rats in the dutasteride group showed more severe renal modifications than those in the finasteride group.

Post-finasteride syndrome

Abstract Finasteride is a 5α-reductase enzyme inhibitor that has been approved for the treatment of male androgenic alopecia since 1997. Over time, it has been considered a safe and well-tolerated drug with rare and reversible side effects. Recently there have been reports of adverse drug-related reactions that persisted for at least three months after discontinuation of this drug, and the term post-finasteride syndrome arose. It includes persistent sexual, neuropsychiatric, and physical symptoms. Studies to date cannot refute or confirm this syndrome as a nosological entity. If it actually exists, it seems to occur in susceptible people, even if exposed to small doses and for short periods, and symptoms may persist for long periods. Based on currently available data, the use of 5α-reductase inhibitors in patients with a history of depression, sexual dysfunction, or infertility should be carefully and individually assessed.

Finasteride promotes worsening of the cardiac deleterious effects of nandrolone decanoate and protects against genotoxic and cytotoxic damage

Metabolism of anabolic androgenic steroids is important for its physiological effects. The aim was to investigate the effects of finasteride (a 5α-reductase inhibitor - 5αR) on cardiac and mutagenic effects promoted by ND. Male Wistar rats were separated into three groups: CONT, received the vehicles of ND and finasteride (Peanut oil+Saline); DECA group, received ND (20 mg.kg.week-1, i.m.), and DECAF received ND and finasteride (100 µg.kg-1, i.p.), for four weeks. After, hypertrophy, cytokines and Angiotensin Converting Enzyme (ACE) activity was determined in heart. Bone marrow was used for micronucleus evaluation. Treatment with ND promotes increase in cardiac hypertrophy, ACE activity and disbalance among pro- and anti-inflammatory cytokines, and combination with finasteride worsened those effects. Association with finasteride ameliorates the toxic effects of ND on bone marrow cells, as was observed by a normalization of the number of micronucleate polychromatic erythrocytes and the mitotic index. Our data demonstrates that deleterious effects promoted by ND are depend, at least in part, of its metabolization. Also, inhibition of 5αR by finasteride present variated effects dependent on organ studied. It can promote increase on cardiac damage and a reduction on mutagenic effects of ND, which demonstrated that dehydronandrolone has diverse role on ND effects..

Clinical effect of addition and subtraction of Xiaojiyinzi prescription in the treatment of bleeding after bipolar vaporization of prostate for benign prostatic hyperplasia / 中国基层医药

Objective To explore the effect of addition and subtraction of Xiaojiyinzi prescription in the treatment of bleeding after bipolar vaporization of prostate for benign prostatic hyperplasia.Methods From June 2013 to June 2017,90 patients with benign prostatic hyperplasia who underwent bipolar electrovaporization in the Traditional Chinese Medicine Hospital of Wenling were selected in this study.The patients were divided into observation group and control group according to a random number table,with 45 cases in each group.The observation group was givenaddition and subtraction of Xiaojiyinzi prescription,while the control group was treated with finasteride orally.The clinical effects of the two groups were compared and analyzed.Results The amount of bleeding in the control group at 3 days,5 days and 7 days after operation were (13.69 ± 1.27) mL,(8.37 ± 1.23) mL,(6.13 ± 0.58) mL,respectively,which in the observation group were (9.22 ± 1.18) mL,(6.12 ± 0.98) mL,(3.98 ± 0.33) mL,respectively,there were statistically significant differences between the two groups (t =17.297,P =0.000,t =9.597,P =0.000,t =21.613,P =0.000).The amount of bleeding in both two groups decreased with the prolongation of time,and the differences were statistically significant between each two moments (all P ＜ 0.05).After treatment,the I-PSS and NIH-CPSI scores in the control group were (13.22 ± 2.95) points and (13.64 ± 4.22) points,respectively,which in the observation group were (8.11 ± 1.35) points and (7.88 ± 3.06) points,respectively,which were lower than those before treatment,and the differences were statistically significant(t =12.286,P =0.000,t =14.359,P =0.000,t =21.041,P =0.000,t =25.989,P =0.000).The scores in the observation group after treatment were lower than those in the control group,and the differences were statistically significant between the two groups (t =8.217,P =0.000,t =7.413,P =0.000).Conclusion Hemorrhage is the most common complication of transurethral resection of prostate in elderly men,which seriously interferes with postoperative recovery.The addition and subtraction of Xiaojiyinzi prescription can reduce bleeding and improve postoperative recovery.

RE-ORGA, a Korean Herb Extract, Can Prevent Hair Loss Induced by Dihydrotestosterone in Human Dermal Papilla Cells

BACKGROUND: Androgenic alopecia (AGA) is the most common type of hair loss. It is likely inherited genetically and is promoted by dihydrotestosterone. 5α-reductase has been proven a good target through finasteride use. However, the pathogenesis of AGA cannot be fully explained based only on dihydrotestosterone levels. OBJECTIVE: To identify similar hairloss inhibition activity of RE-ORGA with mode of action other than finasteride. METHODS: We prepared RE-ORGA from Korean herb mixtures. We performed MTT assays for cytotoxicity, Cell Counting Kit-8 assays for cell proliferation, and western blot to identify expression levels of 5α-reductase and Bax. RNA-sequencing was performed for the expression patterns of genes in dihydrotestosterone-activated pathways. Anti-inflammatory activity was also assessed by the expression levels of tumor necrosis factor-alpha (TNF-α) and interleukin 6. RESULTS: REORGA could promote the proliferation of human dermal papilla cells and showed low cytotoxicity. It also inhibited the expression of 5α-reductases and Bax in the cells. RNA-sequencing results verified that the mRNA expressions of SRD5A1, Bax, transforming growth factor-beta 1 (TGF-β1), and TGF-β1 induced transcript 1 (TGFβ1I1) were decreased, whereas expression of protein tyrosine kinase 2 beta (PTK2β) was more elevated. REORGA also showed anti-inflammatory activity through decreased mRNA levels of TNF-α. CONCLUSION: Transcriptionally, up-regulation of PTK2β and concomitant down-regulation of TGFβ1I1 imply that RE-ORGA can modulate androgen receptor sensitivity, decreasing the expression of 5α-reductase type II and Bax together with TGF-β1 transcripts; RE-ORGA also showed partial anti-inflammatory activity. Overall, RE-ORGA is expected to alleviate hair loss by regulating 5α-reductase activity and the receptor's androgen sensitivity.

Finasteride and Erectile Dysfunction in Patients with Benign Prostatic Hyperplasia or Male Androgenetic Alopecia

Finasteride is primarily used to treat benign prostatic hyperplasia (BPH) and male androgenetic alopecia (MAA). Five-alpha reductase inhibitors (5α-RIs) could induce male sexual dysfunction due to their effects on testosterone and dihydrotestosterone. There is evidence suggesting that 5α-RIs may independently increase the risk of erectile dysfunction (ED). However, many investigators believe that side effects of 5α-RIs will disappear with continuous treatment. Considerable controversy exists regarding the severity and persistence of side effects of finasteride on ED. The aim of this review was to summarize current research studies on finasteride associated with ED. The search strategy used each term of finasteride and ED against PubMed database to identify related studies. ED data reported from available trials for finasteride were summarized and reviewed. Although there is not enough evidence to prove the relationship between finasteride and ED, most studies in this review found that finasteride for BPH was correlated with ED. However, most studies included in this review revealed that finasteride for MAA was not correlated with ED. On the other hand, some studies reported side effects of finasteride associated with sexual dysfunction, including ED, male infertility, ejaculation problem, and loss of libido, even in MAA patients. Well-designed randomized controlled trials are needed to further determine the mechanism and effects of finasteride on ED. However, physicians should discuss with their patients possible long-term effects of finasteride on sexual function, although we do not have evidence showing that adverse events of sexual dysfunction are absolutely associated with 5α-RIs.

Persistent Erectile Dysfunction after Discontinuation of 5-Alpha Reductase Inhibitor Therapy in Rats Depending on the Duration of Treatment

PURPOSE: The current study is aimed to assess whether a longer duration of 5α-reductase inhibitor (5α-RI) exposure was associated with higher rate of permanent erectile dysfunction (ED) in a rat model. MATERIALS AND METHODS: Male Sprague-Dawley rats (n=76) were assigned to five groups: (i) normal control group; (ii) dutasteride (0.5 mg/rat/d) for 4-weeks group; (iii) dutasteride for 4-weeks plus 2-weeks of resting group; (iv) dutasteride for 8-weeks group; and (v) dutasteride for 8-weeks plus 2-weeks of resting group. In vivo erectile responses to electrical stimulation, and changes of fibrotic factors and smooth muscle/collagen contents in the corpus cavernosum were evaluated in each group. RESULTS: Dutasteride administration for 4 and 8 weeks significantly decreased erectile parameters compared with the control group. Reduced erectile responses were recovered during 2 weeks of drug-free time in the 4-week treatment group, but were not in the 8-week group. Protein levels of fibrosis-related factors transforming growth factor (TGF)-β1, TGF-β2, and p-Smad/Smad (Smad 2/3) in the corpus cavernosum showed no significant change after 4 weeks of dutasteride oral administration, but were enhanced after 8 weeks. Dutasteride markedly decreased smooth muscle content and increased collagen after 4 and 8 weeks of use, but no nuclear size changes; however, neither group showed significant improvement in the smooth muscle to collagen ratio after the rest period. CONCLUSIONS: Our study showed that recovery from ED depended on the duration of medication, and administration of dutasteride for more than 8-weeks in rats could result in irreversible ED even after discontinuation of medication.

Local Injections of Botulinum Toxin A in Treatment of Androgenetic Alopecia / 中山大学学报(医学科学版)

[Objective] To determine the efficacy and safety of local injections of botulinum toxin A in the treatment of androgenetic alopecia.[Methods] 72 male patients were randomly into botulinum toxin An group (n=35) and the control group (n=37),the treatment time was 6 months.All the patients were photographed and evaluated,before the treatment,and 3 months and 6 months.[Results] After the treatment of half a year,a good result was observed,the hair density in the treatment group was higher after 3months and 6 months than before the treatment (P＜0.05),but there was no difference between the after 3months and 6 months (P＞0.05),the hair density in the control group was higher after 6 months than before the treatment and after 3 months (P＜0.05),but there was no difference between the after 3 months and before the treatment (P＞0.05);but there was no difference between the after 3 months and 6 months (P＞0.05);After 6 months,the effective ratio and in two group were 91.4％ and 86.5％ in treated group,it showed no significant difference (P＞0.05) [Conclusion] the treatment of local injections of botulinum toxin A has a marked effect on androgenetic alopecia,it is safe and effective.

Effects of Telmisartan Combined with Finasteride on Blood Pressure Rhythm in Non-dipper Type Hypertensive Patients with Prostatic Hyperplasia / 中国药房

OBJECTIVE: To study the effects of telmisartan combined with finasteride on blood pressure rhythm (BPR) in non-dipper type hypertension patients with benign prostatic hyperplasia (BPH). METHODS: From Jul. 2015 to Dec. 2016, medical information of 190 patients with non-dipper type hypertension complicated with BPH were retrospectively collected from Halison International Peace Hospital, and then divided into control group (n=82) and observation group (n=108) according to therapy plan. Control group was given telmisartan 40 mg, qd; observation group was additionally given finasteride 5 mg, qd, on the basis of observation group. Both groups were treated for 12 months, and followed up once every 3 months. The changes of blood pressure (24 hSBP, 24 hDBP, 24 hPP, dSBP, dDBP, dPP, nSBP, nDBP, nPP), morning blood pressure surge, prostate volume, nocturia times, the changes of BPR (the rate of non-dipper type blood pressure change) were observed in 2 groups. The occurrence of ADR was observed. RESULTS: Before treatment, there was no statistical significance in blood pressure, morning blood pressure surge, prostate volume or nocturia times between 2 groups (P>0. 05). After treated for 3, 6, 12 months, blood pressure, morning blood pressure surge, prostate volume, nocturia times and the rate of non-dipper type blood pressure change in 2 groups were decreased significantly; the observation group was significantly lower than the control group, with statistical significance (P>0. 05). There was no statistical significance in the incidence of ADR between 2 groups (P>0. 05). CONCLUSIONS: Telmisartan combined with finasteride show significant effects on non-dipper hypertension complicated with BPH, effectively reduce the level of blood pressure, prostate volume, nocturia times and improve BPR with good safety. The effect of two-drug is better than that of telmisartan.

Finasteride inhibits microvascular density and VEGF expression in the seminal vesicle of rats / 中华男科学杂志

<p><b>Objective</b>To investigate the effect of finasteride on the microvascular density (MVD) and the expression of the vascular endothelial growth factor (VEGF) in the seminal vesicle of rats.</p><p><b>METHODS</b>Forty male SD rats were randomly and equally divided into groups A, B, C and D, those in groups A and B fed with normal saline as the control and those in C and D with finasteride at 40 mg per kg of the body weight per day, A and C for 14 days and B and D for 28 days. Then the seminal vesicles of the animals were harvested for HE staining, measurement of MVD, determination of the expressions of CD34 and VEGF by immunohistochemistry, and observation of histomorphological changes in the seminal vesicle.</p><p><b>RESULTS</b>The expressions of CD34 in groups C and D were decreased by 6.7% and 15.8% as compared with those in A and B (P<0.01), and that in group D decreased by 9.3% in comparison with that in C (P<0.01). The expression indexes of VEGF in groups C and D were decreased by 6.9% and 14.1% as compared with those in A and B (P<0.01), and that in group D decreased by 9.0% in comparison with that in C (P<0.01).</p><p><b>CONCLUSIONS</b>Finasteride can inhibit the expression of VEGF in the seminal vesicle tissue of the rat and hence suppress the angiogenesis of microvessels of the seminal vesicle.</p>

Efficacy of Kangshuailing Gao on benign prostatic hyperplasia in rats / 中华男科学杂志

<p><b>Objective</b>To investigate the effect of Kangshuailing Gao (KG) on benign prostatic hyperplasia (BPH) in rats and its action mechanisms.</p><p><b>METHODS</b>Fifty BPH model rats were randomized into five groups of equal number, BPH model control, finasteride control, and high-, medium- and low-dose KG, to be treated intragastrically with distilled water, finasteride solution at 0.52 mg/kg, and KG solution at 4.16, 2.08 and 1.04 g/kg respectively once a day for 30 days consecutively. Another 10 normal healthy rats were taken as blank controls. The rats were weighed once a week during the treatment. The wet weight and index of the prostate were obtained after treatment, followed by measurement of the contents of serum estradiol (E2) and dihydrotestosterone (DHT), testosterone (T) and hypoxia-inducible factor-1α (HIF-1α) in the prostatic tissue, and observation of histomorphological changes in the prostate under the light microscope.</p><p><b>RESULTS</b>Compared with the BPH model control group, high- and medium-dose KG significantly reduced the prostate wet weight (［0.84 ± 0.08］ vs ［0.69 ± 0.04］ and ［0.71 ± 0.07］ g, P < 0.01), the prostatic index (［0.28 ± 0.03］% vs ［0.20 ± 0.02］% and ［0.22 ± 0.03］%, P < 0.01), and the levels of T (［4.63 ± 1.25］ vs ［2.44 ± 0.47］ and ［2.91 ± 0.69］ ng/L, P < 0.01) and DHT (［154.44 ± 20.25］ vs ［88.23 ± 13.63］ and ［90.52 ± 16.44］ nmol/L, P < 0.01), but increased the level of E2 (［0.95 ± 0.24］ vs ［1.19 ± 0.14］ and ［1.20 ± 0.22］ nmol/L, P < 0.01) in the serum. High-dose KG remarkably reduced the overexpression of HIF-1α in the prostate tissue of the BPH model rats (P < 0.01) and alleviated such BPH-related symptoms as epithelium thinning, intraglandular secretion reduction, and interstitial substance decrease.</p><p><b>CONCLUSIONS</b>Kangshuailing Gao acted effectively on BPH in the model rats by reducing the androgen level, balancing the estrogen/androgen ratio, and downregulating the expression of HIF-1α in the prostate tissue.</p>

The corpus cavernosum after treatment with dutasteride or finasteride: A histomorphometric study in a benign prostatic hyperplasia rodent model / 亚洲男科学杂志(英文版)

Erectile dysfunction is a common side effect of finasteride and dutasteride treatments. The objective of this study was to investigate the structural changes in the penis using a benign prostatic hyperplasia (BPH) rodent model treated with dutasteride or finasteride. Sixty male rats were divided into the following groups: C, untreated control rats; C + D, control rats receiving dutasteride; C + F, control rats receiving finasteride; H, untreated spontaneously hypertensive rats (SHRs); H + D, SHRs treated with dutasteride; and H + F, SHRs treated with finasteride. Treatments were performed for 40 days, and penises were collected immediately thereafter. The organs were analyzed using histomorphometric methods to determine the cross-sectional penile area, as well as the surface density (Sv) of smooth muscle fibers, connective tissue, elastic system fibers, and sinusoidal spaces of the corpus cavernosum. The results were compared using a one-way ANOVA with Bonferroni's posttest. Groups C + D and C + F had a significantly smaller penile cross-sectional area, but more elastic system fiber Sv compared to Group C. Group C + D showed less smooth muscle Sv, and Group H showed more connective tissue but a smaller sinusoidal space Sv in the corpus cavernosum compared to Group C. Groups H + D and H + F had less smooth muscle Sv than Group H. Group H + D also had more connective tissue and elastic system fiber Sv than Group H. Both dutasteride and finasteride promoted penile modifications in the control rat penis, although this affect was greater in Group H animals. In this rodent model, dutasteride was the drug that most affected the corpus cavernosum.

Superiority of dutasteride over fifi nasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia: A randomized controlled open-label, evaluator-blinded study.

Background: Finasteride and dutasteride are inhibitors of the enzyme 5-alpha-reductase which inhibits the conversion of testosterone to dihydrotestosterone. Dutasteride inhibits both type I and type II 5-alpha-reductase while fi nasteride inhibits only the type II enzyme. As both isoenzymes are present in hair follicles, it is likely that dutasteride is more effective than fi nasteride. Aims: To compare the effi cacy, safety and tolerability of dutasteride and fi nasteride in men with androgenetic alopecia. Methods: Men with androgenetic alopecia between 18 and 40 years of age were randomized to receive 0.5 mg dutasteride or 1 mg fi nasteride daily for 24 weeks. The primary effi cacy variables were hair counts (thick and thin) in the target area from modifi ed phototrichograms and global photography evaluation by blinded and non-blinded investigators. The secondary effi cacy variable was subjective assessment using a preset questionnaire. Patients were assessed monthly for side effects. Results: Ninety men with androgenetic alopecia were recruited. The increase in total hair count per cm2 representing new growth was signifi cantly higher in dutasteride group (baseline- 223 hair; at 24 weeks- 246 hair) compared to fi nasteride group (baseline- 227 hair; at 24 weeks- 231 hair). The decrease in thin hair count per cm2 suggestive of reversal of miniaturization was signifi cantly higher in dutasteride group (baseline- 65 hair; at 24 weeks- 57 hair) compared to fi nasteride group (baseline- 67 hair; at 24 weeks- 66 hair). Both the groups showed a similar side effect profi le with sexual dysfunction being the most common and reversible side effect. Limitations: Limitations include the short duration of the study (6 months), the small sample size and the fact that it was an open-label study. Conclusions: Dutasteride was shown to be more effi cacious than fi nasteride and the side-effect profi les were comparable.

Safety and effectiveness of finasteride combined with 1470 nm Semiconductor laser vaporization and resection for Moderate to severe benign prostatic hyperplasia / 中国生化药物杂志

Objective To study the safety and effectiveness finasteride combined with 1470 nm semiconductor laser vaporization and resection for moderate to severe benign prostatic hyperplasia (BPH). Methods A total of 110 consecutives from January to December 2015 were divided randomly into control and observation groups and each of 55 cases; the patients in control group received finasteride combined with transurethral prostatectomy (TURP) and they in observation group adopted finasteride combined with 1470 nm semiconductor laser vaporization and resection, then to compare the differences of surgical success rate,complications rate,mean operation time,blood bloss during and after operation, indwelling catheter time,prostate volume before and after operation; the follow-up time was 12.0 months, the differences of international prostate symptom score (I-PSS), Quality of life score (QOL), peak flow rate (Qmax) peak flow rate (Qmax) and post-void residual (PVR). Results The surgical success rate in the two groups were no statistical difference, the complications rate in observation group was significantly lower (P<0.05). The mean operation time and indwelling catheter time in the two groups were no statistical difference, while the total blood bloss and prostate volume after operation in observation group were both less, and the difference of prostate volume was more (P<0.05). The I-PSS and PVR were lower, QOL and Qmax higher in the two groups after operation, what'more, there were more improvements in observation group (P<0.05). Conclusion It is more prior to finasteride combined with 1470 nm semiconductor laser vaporization and resection for moderate to severe BPH on the Safety and effectiveness than TURP.

Efficacy Observation of Qianliexin Combined with Tamsulosin Hydrochloride and Finasteride in the Treatment of Elderly Benign Prostatic Hyperplasia / 中国药房

OBJECTIVE:To observe the clinical efficacy of qianliexin combined with tamsulosin hydrochloride and finasteride in the treatment of elderly benign prostatic hyperplasia.METHODS:Ninety-four patients diagnosed as benign prostatic hyperplasia in our hospital during May.2012-Oct.2014 were selected and divided into observation group (48 cases) and control group (46 cases) according to even and odd admission number.Both groups received Finasteride tablet 5 mg,po,qd.Basedon this,control group was additionally given Tamsulosin hydrochloride sustained-release capsules 0.2 mg,po,qd;observation group was additionally given Qianliexin capsules 2.5 g,po,tid,on the basis of control group.Clinical efficacies of 2 groups were observed as well as IPSS,BS,IIEF-5 score,ultrasonic measurement indexes and TCM syndrome score before and after treatment.RESULTS:Clinical total response rate of observation group was 93.75％,which was significantly higher than 76.09％ of control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in IPSS,BS,IIEF-5 score,ultrasonic measurement indexes and TCM syndrome score between 2 groups (P＞0.05).After treatment,IPSS and BS score,prostate volume (PV),residual urine(RU),each item score and total score of TCM syndrome were significantly decreased in 2 groups,while IIEF-5 score and Qmax were increased significantly;the observation group was significantly better than the control group,with statistical significance (P＜0.05).CONCLUSIONS:Qianliexin combined with tamsulosin hydrochloride and finasteride shows significant therapeutic effi cacy for elderly benign prostatic hyperplasia,and is helpful to improve prostate symptoms and TCM syndromes,reduce PV and RU,and improve sexual function.

Bawu decoction () ameliorates benign prostatic hyperplasia in rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of Bawu Decoction (, BWD, Palmul-tang in Korean) against benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>Twenty-four male Wistar rats were divided into 4 groups, with 6 rats in each group. The 4 study groups included sham-operated group (CON), BPH model group, fifinasteride-treated group, and BWD-treated group. All the groups except CON group received a subcutaneous injection of 10 mg/kg of testosterone, while CON group received saline. Finasteride at a dose of 5 mg/kg was administered to the finasteride-treated group for a period of 4 weeks. BWD group received BWD at a dose of 200 mg/kg for 4 weeks. The prostatic weight, prostate weight to body weight ratio, relative prostate weight ratio, serum testosterone and dihydrotestosterone (DHT) level, and histological analysis of prostatic tissue were analyzed.</p><p><b>RESULTS</b>Compared to BPH model group, BWD administration was associated with reductions in prostatic weight, prostate and relative prostate weight ratio weight to body weight ratio (P<0.05). The concentration of serum testosterone and DHT were higher in BPH group compared with CON group (P<0.05). Administration of finasteride and BWD suppressed the elevation of serum testosterone and DHT levels signifificantly (both P<0.05). In addition, BWD suppressed the growth of prostatic tissue (P<0.05).</p><p><b>CONCLUSION</b>BWD has suppressant effects on development of BPH through inhibition of serum testosterone and DHT.</p>