Effectiveness of Finasteride on Patients with Male Pattern Baldness Who Have Different Androgen Receptor Gene Polymorphism

Wakisaka, Nagaoki; Taira, Yuh-ichi; Ishikawa, Masahiro; Nakamizo, Yoshio; Kobayashi, Kazuhiro; Uwabu, Masashi; Fukuda, Y.; Taguchi, Yasuyuki; Hama, Takanori; Kawakami, M

doi:10.1111/j.0022-202x.2005.10123.x

Cited by 22 publications

(14 citation statements)

References 5 publications

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“…Under testosterone treatment hypogonadal men with shorter CAG repeats exhibit a more pronounced increase in prostate volume and haematocrit than men with longer CAG repeats 82,83 . By the same token, the effectiveness of finasteride treatment for alopecia is more effective in men with short repeats than in those with long CAG repeats 84 . In addition, the rate of aromatization and 5α‐reduction may show considerable interperson variability and may thereby influence the biological effects of testosterone.…”

Section: Pharmacogeneticsmentioning

confidence: 99%

Testosterone treatment comes of age: new options for hypogonadal men

Nieschlag

2006

Clinical Endocrinology

120

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SummaryMale hypogonadism is one of the most frequent, but also most underdiagnosed, endocrinopathies. However, the required testosterone treatment is simple and very effective if properly administered. Although testosterone has been available for clinical use for seven decades, until quite recently the treatment modalities were far from ideal. Subdermal testosterone pellets require minor surgery for insertion and often cause local problems. The injectable testosterone enanthate, for a long period the most frequently used mode of administration, lasts for two to four weeks, but produces supraphysiological levels initially and low levels before the next injection. The oral testosterone undecanoate has to be taken three times daily, has an uncertain absorption pattern and results in peaks and valleys of serum testosterone levels throughout the day. With the advent of transdermal testosterone preparations, the desired physiological serum levels could be achieved for the first time. Scrotal testosterone patches were the first to fulfil this requirement. These were followed by nonscrotal skin patches, which, however, cause considerable skin reactions including erythema and blisters. Recently introduced, invisible transdermal testosterone gels increased the intervals of application and are now slowly replacing other modalities. A mucoadhesive buccal testosterone tablet with sustained release is also a recent competing modality. Finally, injectable testosterone undecanoate in castor oil was made into a real depot preparation requiring only four injections per year for replacement therapy. These new preparations with a desired pharmacokinetic testosterone profile give the patient a real choice and make treatment easier. Based on pharmacogenetic considerations taking the androgen receptor polymorphism into account, treatment may be individualized for each patient in the future. It was soon recognized that testosterone given orally would be eliminated by the first-pass effect in the liver. Therefore, testosterone was first compressed into pellets and implanted subcutaneously, 8 a modality still in use today. 9 -11 Three 200-mg or six 100-mg pellets maintain their effectiveness for up to half a year. Within the first weeks of application, serum testosterone concentrations increase to very high levels and then decline steadily into the hypogonadal range. The pellets require minor surgery for insertion, often causing local irritation and extrusion, and sometimes infection. 12To make testosterone orally active it was alkylated in position 7, and although patients taking 7 α -methyl testosterone sometimes developed liver toxicity (i.e. peliosis and tumours of the liver), 13 especially when the drug was taken for long periods, it remained in use until alternatives were developed. It has now disappeared, at least from European markets, but the concern about liver toxicity lingers on and is sometimes mistakenly attributed to other testosterone preparations, although natural testosterone never showed such side-effects.14 Mesterolon...

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Section: Pharmacogeneticsmentioning

confidence: 99%

Testosterone treatment comes of age: new options for hypogonadal men

Nieschlag

2006

Clinical Endocrinology

120

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“…In humans, the number of CAG repeats is polymorphic. Expansion of CAG repeats in the AR has clinical implications for human disease 23 …”

Section: Discussionmentioning

confidence: 99%

“…With respect to AGA, patients with a shorter repeat region in the AR gene had more severe hair loss and responded better to finasteride than those with a longer repeat region. 23 In order to investigate whether the functional polymorphism of the AR seen in KD reduces the risk of AGA, we undertook a survey of men affected by KD and compared the prevalence of AGA with that in white men of various ages randomly selected from the electoral roll in Maryborough, Australia. Registration to vote is compulsory in Australia.…”

Section: Discussionmentioning

confidence: 99%

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Men with Kennedy disease have a reduced risk of androgenetic alopecia

et al. 2007

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“…In men with AGA, greater efficacy of finasteride is correlated with shorter CAG repeats of the AR gene, whereas the efficacy in patients with FPHL cannot be predicted with certainty. 36 Topical preparations of finasteride 0.05% have a potential role in the treatment of male AGA and FPHL. 37 Finasteride is metabolized in the liver, and it should be used with caution in patients with liver abnormalities.…”

Section: -A Reductase Inhibitorsmentioning

confidence: 99%