Damkerng Pathomvanich, ISHRS, Valerie Randall

ISHRS 22nd Annual Meeting in Kuala Lumpur, Malaysia

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The International Society of Hair Restoration Surgery (ISHRS) is having its 22nd annual meeting in Kuala Lumpur, Malaysia from October 8-11, 2014.  Surprisingly, this is the first time this conference is being held in Asia, home to over one-half of the world’s population.  As was the case with last year’s conference in San Francisco,  the initial online outline of their program is excellent:

ISHRS 22nd annual meeting

The chair of the conference is the renowned Thailand based surgeon Dr. Damkerng Pathomvanich (also called Dr. Path on the forums). As usual, the majority of the presentations are related to hair transplantation techniques and improvements in that field.  The four main non-hair transplantation related presentations from invited speakers are:

  1. The key Norwood lecture by Dr. Valerie Randall (UK), titled “Is a Glaucoma Drug the Next Treatment for Hair Loss? ”  This of course pertains to the FDA approved drug Bimatoprost, a prostamide/prostaglandin F2α analog that was initially used to stop the progression of glaucoma (and was later also found to grow eyelash hair and has since been sold for that purpose under the brand name Latisse). (My note: this is quite possible going to be the next big thing in terms of hair loss drugs, and I will have to write a post on it soon).
  2. Dr. Rodney Sinclair (Australia)’s lecture titled “Androgenetic Alopecia: New Insights into the Role of the Arrector Pili Muscle in Hair Biology.“
  3. Dr. Desmond Tobin (UK)’s lecture on  “The Aging Scalp and its Hallmark Gray Hair.”
  4. Dr. Thomas Dawson (Singapore — Proctor & Gamble)’s lecture on “Female Aging & Care for Your Hair – Making the Most of What You Have.”  (My note:  what a depressing and discouraging title!).

There are a huge number of interesting presentations related to hair transplantation this time.  In fact the brochure mentions that they received record interest in this regard.  Among the ones I like include:

  • Four unique presentations (all from renowned hair transplant surgeons) related to storage medium for hair grafts.
  • Four presentations on PRP.
  • Various presentations and group sessions on devices and proprietary techniques, many of which I had never heard of before (but are in all likelihood just minor variations in existing tools and in FUT and FUT).
  • Various presentations and group session dedicated to ethnic groups and hair transplantation (e.g., African hair, Chinese hair, Japanese hair, East Asian hair).
  • Dr. Bradley Wolf’s presentation on the genomics comparison of hair follicles from FUT, FUE and plucks.
  • Dr. Sharon Keene’s presentation on LLLT.
  • Dr. John Cole’s discussion group on FUE megasessions.
  • Dr. Robert True’s discussion group on beard FUE.
  • Dr. Arvind Poswal’s discussion group on chest hair FUE.
  • Dr. Ken Washenik and Dr. Rodney Sinclair’s discussion group on understanding cell multiplication and future therapies.
  • Dr. Jerry Cooley’s discussion group on bioenhancements in hair transplantation.
  • Dr. Robert Bernstein’s presentation on robotic (My note: probably ARTAS) recipient site creation.
  • Dr. James Harris’ presentation on the follicular distribution in 176 robot assisted FUE patient cases.
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.