Systemic finasteride for men with AGA Efficacy

We found no systematic review. The 2-year results of the largest RCT were published by Kaufman et al.20 The international multicentre clinical trial of more than 1500 patients demonstrated a significant increase of hair counts in the finasteride treatment group after 1 year (+ 86 hairs per 5.1 cm2 test area versus -21 hairs in the placebo group). In the second year, there was stabilisation of the increased hair count in the finasteride group. Men on placebo had a progressive loss of hair count in the vertex test area. Men who were switched from finasteride to placebo after 1 year lost the hair gained under finasteride. Therefore, as with other medical treatments for AGA, finasteride needs to be taken permanently to show therapeutic benefit. Visible hair density was also documented by a standardised camera device.11 After 1 and 2 years the before and after pictures were judged by an expert panel of dermatologists who were blinded to the treatment modality. After 1 year, 48% of men in the finasteride treatment group had visibly increased hair density in the vertex area, compared with 7% in the placebo group. After 2 years of treatment, 66% of the men in the finasteride group had visibly increased hair density, compared with only 7% in the placebo group.20

Other RCTs have demonstrated that finasteride significantly improves the anagen/telogen ratio21 and has also positive effects on the frontal hair line.22 On the basis of recently published 5-year data,23 hair loss can be stopped in 90% of men taking finasteride, compared with 25% in the placebo group. In addition to stoppage of hair loss, an increase in hair density was seen in 48% of the men in the finasteride group, compared with 6% of men in the placebo group after 5 years of the study.

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