[kevin]

Van HLT, erg interessant en precies wat Dr.Lee tegen mij vertelde:

Topical minoxidil hair-counts vs. dutasteride hair-counts: a modest comparison...

For quite some time now, I've been telling people that from my reading of various topical minoxidil studies and finasteride studies, it appears that minoxidil is more effective at stimulating regrowth than finasteride; an obvious question nowadays would be: where does the very long-awaited dutasteride fit into the grand scheme of things? We have some good data from the dutasteride phase II trial, so does it finally surpass what Rogaine can do? I decided to look at the data from every topical minoxidil study in my collection and make an objective comparison! Since the only reported data in the dutasteride trial were the hair-counts, I could only use minox studies that also reported hair-counts, to get any kind of meaningful comparison; and there are exactly six of them in my collection.

I've given the full citations to the studies at the very end of this post, in case anyone wants to double-check my figures and computations. As I'm reporting the numbers for each one, I'll just refer to them as (1) through (6)...again, you can check at the end to see the full reference. The minox studies lasted for varying lengths of time like 4 months, 6 months, and 12 months, while the Glaxo finasteride and dutasteride trial lasted only for six months; to compensate for that, I've specified the actual length of each individual trial, and then calculated the hair-count increase PER MONTH, for fairness. Also, all hair-counts are standardized to the familiar 1-inch circular test spot on the scalp. Ok...all set? Here we go:

(The Glaxo trial of finasteride and dutasteride)

Finasteride... +72 hairs, six months (12.0 hairs/month)
Dutasteride... +108 hairs, six months (18.0 hairs/month)


(All the following are the topical minox studies)

(1) 2% minox... +425 hairs, 12 months (35.4 hairs/month)
Also: 3% minox... +372 hairs, 12 months (31.0 hairs/month)

(2) 2% minox... +273.4 NONVELLUS hairs, 12 months (22.8 hairs/month)

(3) 2% minox... +101 TERMINAL hairs, 13 months (7.8 terminal hairs/month)

(4) 1% minox... +149 hairs, 6 months (24.8 hairs/month)
Also: 2% minox... +175 hairs, 6 months (29.2 hairs/month)

(5) 2% minox... +233.8 hairs, 12 months (19.5 hairs/month)

(6) 2% minox... +151 hairs, 4 months (37.8 hairs/month)
Also: 2% minox... +324 hairs, 12 months (27 hairs/month)
Also: 3% minox... +166 hairs, 4 months (41.5 hairs/month)
Also: 3% minox... +338 hairs, 12 months (28.2 hairs/month)


There you have all the data! Averaging all the topical minoxidil data shows an average hair-count increase of +25.1 hairs per month (for that study #6, I'm using just the 12-month data), whereas dutasteride only managed a hair-count increase of +18.0 hairs per month! Finasteride brings up the rear at only +12.0 hairs per month! Summarizing the data is very simple and elegant: dutasteride generates about 50% more regrowth than finasteride (we've been saying that for a long time), and topical minoxidil generates about 50% more regrowth than dutasteride, according to all these studies! And here's a small but important detail: the minoxidil hair-counts are actually a little UNDERestimated, because the numbers reported for studies #2 and #3 were for nonvellus and terminal hairs, respectively. Factoring in TOTAL hair-counts (which weren't reported in those two studies) would make regrowth from topical minoxidil even more impressive.

Bottom line: as I've been saying for a long time, dutasteride is a fine new addition to our weaponry, but it should be considered a potent agent to inhibit the balding process itself, and not really something that's going to stimulate a lot of extra regrowth. For that, you'll have to use a complete program that addresses all the known angles that we've been talking about, like minoxidil, SODs, etc. By no means is dutasteride all by itself any kind of ultimate "cure" for balding; at least, not if any serious regrowth is one of your goals. But if all you need to do is maintain, then it should be an outstanding new drug for you, even by itself.

Bryan


(1) "Topical Minoxidil in Early Androgenetic Alopecia", Kreindler et al, J Am Acad Dermatol 1987;16:718-24.

(2) "Five-Year Follow-Up of Men With Androgenetic Alopecia Treated With Topical Minoxidil", Olsen et al, J Am Acad Dermatol 1990;22:643-6.

(3) "Duration of Minoxidil Therapy to Yield Maximum Benefit", [Letter] Rietschel et al, Arch Dermatol 1988;124:1569-70.

(4) "Dose-Response Study of Topical Minoxidil in Male Pattern Baldness", Olsen et al, J Am Acad Dermatol 15:30-37, 1986.

(5) "Topical Minoxidil Therapy for Androgenetic Alopecia", Koperski et al, Arch Dermatol 1987;123:1483-1487.

(6) "Topical Minoxidil in Early Male Pattern Baldness", Olsen et al, J Am Acad Dermatol 13:185-192, 1985.