Wider Clinical Applications of Fumaric Acid Esters: A Useful Option in Psoriasis Patients with Multiple Sclerosis

The document reports on a large observational cohort study that investigated the risk of sexual dysfunction in young men under 42 years old who were prescribed finasteride at a dose of ≤1.25 mg/day for androgenic alopecia (AA). The study analyzed data from an electronic medical record database of 157,998 healthy men with no prior sexual dysfunction, good physical and mental health, and no significant abnormalities on screening. The results showed that men exposed to finasteride had a significantly increased risk of impotence (hazard ratio [HR] = 3.06), use of phosphodiesterase-5 inhibitors (HR = 4.8), and diminished libido (HR = 4.9) compared to men not exposed to finasteride or any other 5-alpha reductase inhibitors. The study concluded that there is a highly statistically significant risk of sexual dysfunction in men under 42 prescribed finasteride for AA, with the hazard ratio for developing impotence or diminished libido being considerably higher than reported in clinical trials. This indicates a need for increased awareness of these risks in the dermatology community. No commercial support was identified for the study.