Zhang Jun-Jie, Shi Xiao, Wu Ting, Zhang Meng-Da, Tang Jin, Yin Guang-Ming, Long Zhi, He Le-Ye, Qi Lin, Wang Long
Department of Urology, The Third Xiangya Hospital, Central South University, Changsha 410008, China.
Department of Urology, Xiangya Hospital, Central South University, Changsha 410013, China.
Asian J Androl. 2022 Jul-Aug;24(4):390-397. doi: 10.4103/aja202171.
Postfinasteride syndrome (PFS) is a term coined to characterize a constellation of reported undesirable sexual, physical, and neuropsychiatric side effects. In the present study, we conducted the meta-analysis to demonstrate whether the use of 5α-reductase inhibitors (5ARIs) increases the risk of PFS-like adverse effects. A search of studies published until May 10, 2020, was performed using PubMed, EMBASE, and the Cochrane Library. We included randomized controlled trials with at least one comparison between male patients receiving 5ARIs versus placebo for the treatment of benign prostatic hyperplasia (BPH) or androgenetic alopecia (AGA), and identified 34 studies from 28 articles that met our eligibility criteria. In the random-effects model, the overall use of 5ARIs exhibited a 1.87-fold risk of PFS-like adverse effects during the trial (95% confidence interval [CI]: 1.64-2.14). Regarding specific types of adverse effects, the use of 5ARIs had a 1.89-fold risk of sexual adverse effects (95% CI: 1.74-2.05) and was associated with an increased risk of physical adverse effects (relative risk [RR]: 1.31, 95% CI: 0.80-2.15), albeit without statistical significance. This meta-analysis helped to better define the adverse effects caused by 5ARIs. We concluded that the overall use of 5ARIs significantly increased the risk of PFS-like adverse effects in men with AGA or BPH during treatment. Enhanced awareness of and education on the PFS-like adverse effects are necessary for clinicians.
非那雄胺后综合征（PFS）是一个创造出来的术语，用于描述一系列报告的不良性、身体和神经精神方面的副作用。在本研究中，我们进行了荟萃分析，以证明使用5α-还原酶抑制剂（5ARIs）是否会增加类似PFS的不良反应风险。我们使用PubMed、EMBASE和Cochrane图书馆对截至2020年5月10日发表的研究进行了检索。我们纳入了至少有一组男性患者接受5ARIs与安慰剂比较以治疗良性前列腺增生（BPH）或雄激素性脱发（AGA）的随机对照试验，并从28篇文章中确定了34项符合我们纳入标准的研究。在随机效应模型中，在试验期间，5ARIs的总体使用表现出类似PFS不良反应的1.87倍风险（95%置信区间[CI]：1.64 - 2.14）。关于特定类型的不良反应，使用5ARIs有1.89倍的性不良反应风险（95% CI：1.74 - 2.05），并且与身体不良反应风险增加相关（相对风险[RR]：1.31，95% CI：0.80 - 2.15），尽管没有统计学意义。这项荟萃分析有助于更好地界定5ARIs引起 的不良反应。我们得出结论，在治疗AGA或BPH男性患者时，5ARIs的总体使用显著增加了类似PFS不良反应的风险。临床医生有必要提高对类似PFS不良反应的认识并开展相关教育。
