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Long-term (10-year) efficacy of finasteride in 523 Japanese men with androgenetic alopecia
We evaluated the long-term (10-year) efficacy and safety of AGA treatment with 1 mg/day finasteride in a large study population (532 patients), as the first study of this kind in Japan, to our knowledge. A high objective efficacy was demonstrated by the MGPA, which revealed improvement and prevention of disease progression in 99.1% of the 532 Japanese men with AGA treated with 1 mg/day finasteride for 10 years. Furthermore, the outcome was similar to or better than that reported by other studies in Japan [8-10,13,17]. Differences have been known to occur in the progression of AGA symptoms between Japanese and Caucasian men [8,18]. This efficacy of the investigated treatment in Japanese men exceeded that reported in other studies in Caucasians. The superior response of Japanese men with AGA was reported to likely be attributable to their hair characteristics (greater diameter, black color, and lower density), which facilitated the detection of slight changes [10,19-23]. A novel finding observed in this study was the significant difference in the improvement of AGA following finasteride treatment between the N-H: I/II/III and N-H: IV/V/VI/VII groups at the first visit. The ROC analysis revealed a similar difference, that was performed to classify patients with improvement (MGPA≥5) and deteriorating (MGPA<5) condition at year 10 of treatment; the cut-off point was N-H: III (AUC: 0.746). Furthermore, the MGPA of the total study population and the N-H: I/II/III group at the first visit significantly improved from treatment year 5 to 10 (P<0.001). This efficacy was different from that of a 5-year study in Japanese men, which reported that the efficacy began to plateau after 4 years of treatment [10]. Several studies have reported that AGA progresses in N-H classification with age, [7,11,12,18] and that younger patients show more improvement than that of older patients with AGA treatment [24,25]. In this study, AGA patients at the early stage of N-H classification showed more improvement than patients at the later stage did.
Results
Patient Characteristics
The characteristics of all patients evaluated for AGA treatment efficacy were as follows: age at first visit, 37.8 ± 10.0 years; age range, 20–69 years; and values of each N-H at the first visit: I/II/III/IV/V/VI/VII, 6/116/204/124/61/18/3, respectively.
Efficacy Evaluation in 10 years treatment
Objective efficacy - Scalp photographs
The proportions of patients with improvement (MGPA ≥ 5) or prevention of disease progression (MGPA ≥ 4) at treatment year 10 were 91.5% (487/532) and 99.1% (527/532), respectively. The efficacy evaluation showed that the MGPA improved significantly from year 1 through to year 10 of treatment compared with the baseline (MGPA = 4). The MGPA of each N-H group was linear according to the N-H number; the total was between N-H:III and N-H:IV (Figure 4 and Table 1). Receiver operating characteristic curve (ROC) analysis was performed to classify patients with improvement (MGPA ≥ 5) and deteriorating (MGPA<5) condition at year 10 of treatment; the cut-off point was N-H: III. (the area under the curve [AUC], which indicates the predictive value, was 0.746.). Furthermore, the MGPA of the total study population and the N-H:I/II/III group at the first visit improved from year 5 through to year 10, with statistically significant differences (P<0.001). The early stage AGA group (N-H: I/II/III at first visit) showed more improvement with long-term AGA treatment (10-year) with finasteride than the other groups did in the objective evaluation. The N-H classification of AGA patients improved by approximately 1 grade over the 10-year treatment with finasteride; significant differences were observed from pre-treatment (3.35 ± 1.11) to post-treatment (2.55 ± 1.30, P<0.001) in comparison of digitized classification.
Figure 4. Changes in modified global photographic assessment scores (MGPA) from before treatment through year 10 of treatment on each Norwood-Hamilton scale (N-H) group at first visit.
Safety Evaluation
During the study period for 10 years, no serious adverse reaction was recognized. Mild and temporary adverse reactions were recorded in 6.8% (36⁄532) of the entire study population by questionnaire. The adverse reactions were decreased libido (5.6%, n=30) and erectile dysfunction (3.0%, n=16). All adverse reactions were mild and all patients continued treatment for 10 years.
- more hair
- less cortisol (no worrying about hairline recession)
- more dopamin (no worrying about hairline recession)
- better sleep (no worrying about hairline recession)
- cure of depression (no worrying about hairline recession)
We evaluated the long-term (10-year) efficacy and safety of AGA treatment with 1 mg/day finasteride in a large study population (532 patients), as the first study of this kind in Japan, to our knowledge. A high objective efficacy was demonstrated by the MGPA, which revealed improvement and prevention of disease progression in 99.1% of the 532 Japanese men with AGA treated with 1 mg/day finasteride for 10 years. Furthermore, the outcome was similar to or better than that reported by other studies in Japan [8-10,13,17]. Differences have been known to occur in the progression of AGA symptoms between Japanese and Caucasian men [8,18]. This efficacy of the investigated treatment in Japanese men exceeded that reported in other studies in Caucasians. The superior response of Japanese men with AGA was reported to likely be attributable to their hair characteristics (greater diameter, black color, and lower density), which facilitated the detection of slight changes [10,19-23]. A novel finding observed in this study was the significant difference in the improvement of AGA following finasteride treatment between the N-H: I/II/III and N-H: IV/V/VI/VII groups at the first visit. The ROC analysis revealed a similar difference, that was performed to classify patients with improvement (MGPA≥5) and deteriorating (MGPA<5) condition at year 10 of treatment; the cut-off point was N-H: III (AUC: 0.746). Furthermore, the MGPA of the total study population and the N-H: I/II/III group at the first visit significantly improved from treatment year 5 to 10 (P<0.001). This efficacy was different from that of a 5-year study in Japanese men, which reported that the efficacy began to plateau after 4 years of treatment [10]. Several studies have reported that AGA progresses in N-H classification with age, [7,11,12,18] and that younger patients show more improvement than that of older patients with AGA treatment [24,25]. In this study, AGA patients at the early stage of N-H classification showed more improvement than patients at the later stage did.
Results
Patient Characteristics
The characteristics of all patients evaluated for AGA treatment efficacy were as follows: age at first visit, 37.8 ± 10.0 years; age range, 20–69 years; and values of each N-H at the first visit: I/II/III/IV/V/VI/VII, 6/116/204/124/61/18/3, respectively.
Efficacy Evaluation in 10 years treatment
Objective efficacy - Scalp photographs
The proportions of patients with improvement (MGPA ≥ 5) or prevention of disease progression (MGPA ≥ 4) at treatment year 10 were 91.5% (487/532) and 99.1% (527/532), respectively. The efficacy evaluation showed that the MGPA improved significantly from year 1 through to year 10 of treatment compared with the baseline (MGPA = 4). The MGPA of each N-H group was linear according to the N-H number; the total was between N-H:III and N-H:IV (Figure 4 and Table 1). Receiver operating characteristic curve (ROC) analysis was performed to classify patients with improvement (MGPA ≥ 5) and deteriorating (MGPA<5) condition at year 10 of treatment; the cut-off point was N-H: III. (the area under the curve [AUC], which indicates the predictive value, was 0.746.). Furthermore, the MGPA of the total study population and the N-H:I/II/III group at the first visit improved from year 5 through to year 10, with statistically significant differences (P<0.001). The early stage AGA group (N-H: I/II/III at first visit) showed more improvement with long-term AGA treatment (10-year) with finasteride than the other groups did in the objective evaluation. The N-H classification of AGA patients improved by approximately 1 grade over the 10-year treatment with finasteride; significant differences were observed from pre-treatment (3.35 ± 1.11) to post-treatment (2.55 ± 1.30, P<0.001) in comparison of digitized classification.
Figure 4. Changes in modified global photographic assessment scores (MGPA) from before treatment through year 10 of treatment on each Norwood-Hamilton scale (N-H) group at first visit.
Safety Evaluation
During the study period for 10 years, no serious adverse reaction was recognized. Mild and temporary adverse reactions were recorded in 6.8% (36⁄532) of the entire study population by questionnaire. The adverse reactions were decreased libido (5.6%, n=30) and erectile dysfunction (3.0%, n=16). All adverse reactions were mild and all patients continued treatment for 10 years.
Me personally, after 2 months of Finasteride daily I have noticed several side effectsLong-term (10-year) efficacy of finasteride in 523 Japanese men with androgenetic alopecia
We evaluated the long-term (10-year) efficacy and safety of AGA treatment with 1 mg/day finasteride in a large study population (532 patients), as the first study of this kind in Japan, to our knowledge. A high objective efficacy was demonstrated by the MGPA, which revealed improvement and prevention of disease progression in 99.1% of the 532 Japanese men with AGA treated with 1 mg/day finasteride for 10 years. Furthermore, the outcome was similar to or better than that reported by other studies in Japan [8-10,13,17]. Differences have been known to occur in the progression of AGA symptoms between Japanese and Caucasian men [8,18]. This efficacy of the investigated treatment in Japanese men exceeded that reported in other studies in Caucasians. The superior response of Japanese men with AGA was reported to likely be attributable to their hair characteristics (greater diameter, black color, and lower density), which facilitated the detection of slight changes [10,19-23]. A novel finding observed in this study was the significant difference in the improvement of AGA following finasteride treatment between the N-H: I/II/III and N-H: IV/V/VI/VII groups at the first visit. The ROC analysis revealed a similar difference, that was performed to classify patients with improvement (MGPA≥5) and deteriorating (MGPA<5) condition at year 10 of treatment; the cut-off point was N-H: III (AUC: 0.746). Furthermore, the MGPA of the total study population and the N-H: I/II/III group at the first visit significantly improved from treatment year 5 to 10 (P<0.001). This efficacy was different from that of a 5-year study in Japanese men, which reported that the efficacy began to plateau after 4 years of treatment [10]. Several studies have reported that AGA progresses in N-H classification with age, [7,11,12,18] and that younger patients show more improvement than that of older patients with AGA treatment [24,25]. In this study, AGA patients at the early stage of N-H classification showed more improvement than patients at the later stage did.
Results
Patient Characteristics
The characteristics of all patients evaluated for AGA treatment efficacy were as follows: age at first visit, 37.8 ± 10.0 years; age range, 20–69 years; and values of each N-H at the first visit: I/II/III/IV/V/VI/VII, 6/116/204/124/61/18/3, respectively.
Efficacy Evaluation in 10 years treatment
Objective efficacy - Scalp photographs
The proportions of patients with improvement (MGPA ≥ 5) or prevention of disease progression (MGPA ≥ 4) at treatment year 10 were 91.5% (487/532) and 99.1% (527/532), respectively. The efficacy evaluation showed that the MGPA improved significantly from year 1 through to year 10 of treatment compared with the baseline (MGPA = 4). The MGPA of each N-H group was linear according to the N-H number; the total was between N-H:III and N-H:IV (Figure 4 and Table 1). Receiver operating characteristic curve (ROC) analysis was performed to classify patients with improvement (MGPA ≥ 5) and deteriorating (MGPA<5) condition at year 10 of treatment; the cut-off point was N-H: III. (the area under the curve [AUC], which indicates the predictive value, was 0.746.). Furthermore, the MGPA of the total study population and the N-H:I/II/III group at the first visit improved from year 5 through to year 10, with statistically significant differences (P<0.001). The early stage AGA group (N-H: I/II/III at first visit) showed more improvement with long-term AGA treatment (10-year) with finasteride than the other groups did in the objective evaluation. The N-H classification of AGA patients improved by approximately 1 grade over the 10-year treatment with finasteride; significant differences were observed from pre-treatment (3.35 ± 1.11) to post-treatment (2.55 ± 1.30, P<0.001) in comparison of digitized classification.
Figure 4. Changes in modified global photographic assessment scores (MGPA) from before treatment through year 10 of treatment on each Norwood-Hamilton scale (N-H) group at first visit.
Safety Evaluation
During the study period for 10 years, no serious adverse reaction was recognized. Mild and temporary adverse reactions were recorded in 6.8% (36⁄532) of the entire study population by questionnaire. The adverse reactions were decreased libido (5.6%, n=30) and erectile dysfunction (3.0%, n=16). All adverse reactions were mild and all patients continued treatment for 10 years.
- more hair
- less cortisol (no worrying about hairline recession)
- more dopamin (no worrying about hairline recession)
- better sleep (no worrying about hairline recession)
- cure of depression (no worrying about hairline recession)
