A meta-analysis of the relative efficacy of minoxidil and the 5-α reductase inhibitors dutasteride and finasteride in the treatment of male androgenetic alopecia has shown that oral dutasteride 0.5 mg/day may achieve the best results. The study was published online Feb. 2, 2022 in JAMA Dermatology.
The authors, including Dr. Aditya K. Gupta of London, Ont., analyzed 23 trials to assess the efficacy of three commonly used monotherapies for androgenetic alopecia: oral and topical minoxidil, dutasteride and finasteride. The relative efficacy was determined using four endpoints: change in total and terminal hair count per square centimetres after 24 and 48 weeks. The mean age of the patients ranged from 22.8 years to 41.8 years.
According to the authors, the results of their investigation indicated that 0.5 mg/d oral dutasteride has the highest probability of being the most efficacious treatment, followed by (in decreasing order of efficacy): 5 mg/d oral finasteride, 5 mg/d oral minoxidil, 1 mg/d oral finasteride, 5% topical minoxidil, 2% topical minoxidil, and 0.25 mg/d oral minoxidil.
The investigators report that this meta-analysis was conducted to contribute to the comparative effectiveness literature for androgenetic alopecia therapies, and to help address some of the clinical knowledge gaps regarding the effectiveness of these three treatments.