Motofei Ion G, Rowland David L, Baconi Daniela L, Tampa Mircea, Sârbu Maria-Isabela, Păunică Stana, Constantin Vlad D, Bălălău Cristian, Păunică Ioana, Georgescu Simona Roxana
a Faculty of General Medicine , Carol Davila University, St. Pantelimon Hospital , Bucharest , Romania.
b Department of Psychology , Valparaiso University , Valparaiso , IN , USA.
Expert Opin Drug Saf. 2018 Apr;17(4):407-412. doi: 10.1080/14740338.2018.1430765. Epub 2018 Jan 24.
Androgenetic alopecia (AGA) is a benign condition with variable psychosocial impact, with some individuals adapting well while others needing therapeutic support. Although 5α-reductase inhibitors like finasteride and dutasteride have proven effective in ameliorating AGA, their use/selection is currently a subject of debate.
Treatment of AGA with 5α-reductase inhibitors lead to variable adverse effects and relatively unstable results (therapeutic efficacy ending with treatment cessation), so the choice of optimal therapy is not straightforward. This paper presents a general perspective regarding AGA based on studies listed in PubMed, to better understand/appreciate the opportunity for long term use of medication for a biological condition having non-life threatening implications. Studies focussed on adverse effects suggest that finasteride should be used with caution in AGA, due to considerable and persistent side effects induced in some men. In contrast, efficacy data indicate that dutasteride (a stronger inhibitor) presents superior therapeutic results compared to finasteride.
This paper argues that finasteride should be preferred to dutasteride in the treatment of AGA. Thus, finasteride preserves important physiological roles of dihydrotestosterone (unrelated to AGA) and, in addition, its adverse effects seem to be (at least in part) predictable.
雄激素性脱发（AGA）是一种良性疾病，对心理社会有不同程度的影响，一些人能很好地适应，而另一些人则需要治疗支持。尽管非那雄胺和度他雄胺等5α-还原酶抑制剂已被证明对改善AGA有效，但目前它们的使用/选择存在争议。
用5α-还原酶抑制剂治疗AGA会导致不同的不良反应和相对不稳定的结果（治疗效果在停药后结束），因此选择最佳治疗方法并非易事。本文基于PubMed上列出的研究，对AGA提出一个总体观点，以便更好地理解/认识到对一种无生命威胁的生物学状况长期使用药物的机会。关注不良反应的研究表明，由于一些男性会出现相当多且持续的副作用，非那雄胺在AGA治疗中应谨慎使用。相比之下，疗效数据表明，度他雄胺（一种更强的抑制剂）与非那雄胺相比具有更好的治疗效果。
本文认为在AGA治疗中，非那雄胺应优于度他雄胺。因此，非那雄胺保留了二氢睾酮的重要生理作用（与AGA无关），此外，其不良反应似乎（至少部分）是可预测的。
