The relative efficacy of treatment options for male androgenetic alopecia (AGA) are compared in a meta-analysis published online Feb. 2 in JAMA Dermatology .

Aditya K. Gupta, M.D., Ph.D., from Mediprobe Research Inc. in London, Ontario, Canada, and colleagues conducted a systematic review to examine the relative efficacy of any dose and administration route of minoxidil, dutasteride, and finasteride for treatment of male AGA. Data from 23 studies were eligible for quantitative analyses after two stages of screening.

The researchers found that at 24 weeks, the greatest increase in total hair count was with 0.5 mg/d of dutasteride, which was significantly more efficacious than 1 mg/d finasteride (mean difference, 7.1 hairs/cm ² ) and minoxidil 0.25 mg/d, 5 mg/d, and 2 percent solution (mean differences, 23.7, 15.0, and 8.5 hairs/cm ² , respectively). At 24 weeks, the greatest increase in terminal hair count was with 5 mg/day minoxidil, which was significantly more efficacious than the 0.25 mg/d dose and its topical forms and was more efficacious than 1 mg/d finasteride. At 48 weeks, the greatest increase in total hair count was with 5 mg/d finasteride, which was significantly more efficacious than 3 percent topical minoxidil, while the greatest increase in terminal hair count was with 1 mg/d finasteride, which was significantly more effective than topical minoxidil.

"While the findings of Gupta et al help us understand the relative efficacy for available AGA treatments, it also highlights the paucity of therapeutic options for this condition," write the authors of an accompanying editorial.

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