Efficacy and Safety of Finasteride Therapy for Androgenetic Alopecia

The document from 2010 is a meta-analysis of 12 randomized controlled trials involving 3,927 male patients, which evaluated the efficacy and safety of finasteride therapy for androgenetic alopecia. The analysis found that finasteride was more effective than placebo in improving hair growth according to patient self-assessment, hair count, and investigator assessment in both short-term (≤12 months) and long-term (≥24 months) studies. The number needed to treat for one patient to perceive improvement was 5.6 in the short term and 3.4 in the long term, with hair count increases of 9.42% and 24.3% respectively. However, finasteride also increased the risk of erectile dysfunction with a relative risk of 2.22, although it did not significantly affect libido or ejaculation dysfunction, and the risk of discontinuing treatment due to sexual adverse effects was similar to placebo. The evidence was of moderate quality, indicating that finasteride is effective for hair growth in men with androgenetic alopecia but has an associated risk of sexual dysfunction. The recommended daily dose is 1 mg, as no significant difference was found between 1 mg and 5 mg doses. The study's strengths include a comprehensive search and sophisticated statistical analysis, but it is limited by potential publication bias and the inclusion of mostly industry-funded trials.