What has happened to dutasteride hair loss study?

At the moment the only FDA (the Food and Drug Administration in the US) approved hair loss treatments are Propecia (generic name finasteride) and Rogaine (minoxidil). Although it is not exactly known how Rogaine works in promoting new growth of hair, the working mechanism of finasteride has been well described. Finasteride protects the hair follicles from harmful effects of dihydrotestosterone (DHT) by reducing its serum levels (this drug was originally used to relieve urinary problems caused by benign prostatic enlargement before its positive hair properties were discovered). DHT is a natural metabolite of the male hormone testosterone which is also available in female bodies and can thus cause hair loss in women. Since this discovery researchers started looking for alternatives to finasteride among natural substances as well as medicinal drugs that are supposed to possess similar working mechanisms. Their philosophy is to identify substances that by interfering with DHT production and by helping to relieve urinary problems could also be used to protect hair follicles from miniaturization and consequent hair loss.

One such compound is dutasteride. It is quite similar in its chemical structure and a mode of action to finasteride but it is more powerful in blocking DHT (it blocks both isoforms of 5-alpha-reductase enzyme that facilitates the conversion of testosterone into DHT) and, therefore, it is expected to be more effective in protecting hair follicles and stopping hair loss than finasteride. GlaxoSmithKline, the originator of Avodart (dutasteride) finished the Phase III. clinical study of dutasteride’s application for treating hair loss already in 2009 but results have not been released to public scrutiny yet and thus the drug was not approved by the FDA for treating hair loss.

The main question mark is whether dutasteride is any more effective in stopping hair loss than finasteride and, secondly, whether its side effects are not too bad to discourage this treatment. Preliminary data that were made available to the public showed that dutasteride in doses of 0.5mg daily might be more effective in protecting and regrowing hair in the frontal area of the scalp than Propecia (finasteride 1mg daily) whereas its side effects were not observed to be any more severe than those of its counterpart finasteride. However, dutasteride is reported to stay longer in the human blood and body and, therefore, its side effects can be felt longer after abandoning the treatment. The final decision by the FDA is still pending but some hair restoration doctors already prescribe Avodart (dutasteride) to their male hair loss patients who, for one reason or another, do not satisfactorily respond to finasteride. Some hair loss patients have been reported to use Avodart for years now while managing to improve their hair regrowth and staying away from bad side-effects but it is advisable to wait for the final study results and the expected approval of dutasteride for treating hair loss.

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