Abstract

GRIJO, Leonor; CARDOSO, Sofia  and  BEIRAO, Liliana. What is the role of 5α-reductase inhibitors in the management of androgenetic alopecia? An evidence-based review. Rev Port Med Geral Fam [online]. 2020, vol.36, n.2, pp.135-143. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i2.12598.

Introduction: Androgenetic alopecia is the most frequent form of alopecia. Both genetic and hormonal factors - these last ones mediated by dihydrotestosterone (DHT) (formed from testosterone in a reaction catalyzed by the enzyme 5α-reductase) contribute to its onset. Some studies have demonstrated the benefit of 5α-reductase inhibitors in the treatment of androgenetic alopecia. Objective: To determine the evidence of the treatment with 5α-reductase inhibitors in adults with androgenetic alopecia. Methods: In March 2019, we did research of evidence-based guidelines, meta-analysis (MA), systematic reviews (RS) and randomized controlled trials (RCTs) in MEDLINE and online evidence-based medicine websites. The search was limited to publications between 01/01/2009 and 08/03/2019, in Portuguese, English, and Spanish, using the MeSH terms ‘Alopecia’ and ‘5-alpha reductase inhibitors’. To rate the quality of a study and the strength of a recommendation we used the scale Strength of Recommendation Taxonomy (SORT) of the American Academy of Family Physicians. Results: In total, 91 potentially relevant papers were identified and 5 met the inclusion criteria: four MA and one RS. Overall, the studies seem to show that 5α-reductase inhibitors are effective in the treatment of androgenetic alopecia. Conclusions: 5α-reductase inhibitors may be effective in the treatment of androgenetic alopecia and with a strength of recommendation B (SORT). Future RCT are needed to clarify if there is a preferred drug within this class, as well as the dose and duration that allows the greatest benefit with the least risk of adverse effects. It is also necessary to clarify if the benefits of the therapy are the same in both genders.

Keywords : Alopecia; 5α-reductase inhibitors.

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