Avodart, Dutasteride, GlaxoSmithKline

GSK Publishes Japanese Dutasteride Study Results

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I previously wrote about dutasteride possibly being approved by the US FDA to treat hair loss in 2015.  In August 2014, GlaxoSmithKline (GSK) published 6-month interim results from a Japanese clinical study of 120 male patients with androgenetic alopecia taking 0.5 mg of dutasteride daily.  You can also download the findings by clicking on the Result Summary tab here and then clicking on the pdf link there.

It should be noted that all patients were Japanese and four patients withdrew from the trial.  Key findings:

  1. 81 percent of patients saw at least some increase in vertex hair count (10 percent saw a great increase, 33 percent saw a moderate increase).
  2. 71 percent of patients saw at least some increase in frontal hair count (8 percent saw a great increase, 32 percent saw a moderate increase).
  3. Only one patient saw a decrease in vertex hair count, and only one patient saw a decrease in frontal hair count.  It is not clear if this was the same patient.  Both saw only a slight decrease.
    (My note: For all intents and purposes, this implies that Dutasteride guarantees at the very least hair loss cessation after 6 months of use).
  4. 11 percent of patients reported erectile dysfunction as a side effect and slightly smaller percentages of patients reported decreased libido, ejaculation disorders and sexual dysfuntion.(My note: Since each patient can report more than one side effect, I am guessing that most of the 11 percent reporting erectile dysfunction also reported the other sexual side effects I listed above.  However, the end of the pdf states that 38 percent of patients had side effects, which I think is an error as they are ignoring multiple side effect reports).

For 6 months, I found the hair loss related results slightly better than expected, but the side effects slightly worse than expected.  I am assuming here that something like 15-20 percent of patients had side effects rather than 38 percent as reported, based on my assumption that multiple side effects on one person were reported individually (i.e., double, triple… counted) for some reason.

If 38 percent of patients really did get side effects, we will not see Dutasteride getting approved to treat hair loss in the US or Japan in my opinion.

Benoxaprofen, Ruxolitinib, Tofacitinib

Before Ruxolitinib and Tofacitinib, there was Benoxaprofen

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I have made many recent posts concerning JAK inhibitors Ruxolitinib and Tofacitinib. These posts have resulted in numerous skeptical reader comments about the potential of these anti-inflammatory drugs to cure male pattern baldness (MPB). In a similar manner to what they have been able to do for alopecia areata (AA).

I have been somewhat optimistic about the potential of these drugs to at least have a moderate positive impact on MPB reversal for a lot of patients. I think that MPB also has an inflammatory component to it, especially in those who get itching and dandruff type symptoms in tandem with their hair loss. This is just a hunch, but the below discovery of mine has made me feel good about my guess.

Benaxoprofen and Hair Growth

This week, I read an interesting article posted on a hair loss forum thread regarding a much older anti-inflammatory drug called Benoxaprofen. Apparantly, Benaxoprofen led to regrowth of hair in two men suffering from MPB. One of these two was 75 years old and had been balding since the age of 45! This article was published in 1982, which was unfortunately also around the time when Benoxaprofen was banned due to major side effects.

I am hopeful that the newer anti-inflammatory drugs such as Ruxolitinib and Tofacitinib will result in far fewer side effects than was the case with Benoxaprofen. I would not want to try either of them until we have good data on the results and side effects experienced by the many patients with alopecia universalis or alopecia totalis who are taking these drugs in various studies. It is not worth getting hair back if there are major treatment associated side effects.

Many readers are certain that the biological mechanisms behind androgenetic alopecia have absolutely no similarities to alopecia areata. However, just remember that it was only recently that scientists started discovering other aspects behind MPB beyond just the age old conclusion of it all being due to dihydrotestosterone (DHT).

This conclusion was a bit too simplistic, since Finasteride and other stronger DHT inhibitors such as Dutasteride rarely give truly great results. Newer hair loss research has resulted in some groundbreaking findings, such as the strong relationship between fat cells, PGD2, PGE2, Wnt7b and hair loss. There have also been new recent developments when it comes to scientists finally figuring out how Minoxidil works after decades of uncertainty and sometimes incorrect hypotheses.

It should also be noted that scientists have found a strong correlation between MPB and heart disease. Not surprisingly, heart disease has an inflammatory component to it according to many reports.