Finpecia Androgenic Alopecia (Male-pattern baldness – Common baldness) Commonest type of hair loss. May be a physiological process. Prevalence rate is. - презентация

1 Finpecia Androgenic Alopecia (Male-pattern baldness – Common baldness) Commonest type of hair loss. May be a physiological process. Prevalence rate is almost 100% in certain races. Mode of inheritance unknown.

2 Finpecia Pathophysiology Normally; On the top: Androgen-sensitive follicles On the sides and back of the scalp: androgen- independent follicles In genetically predisposed individuals ;(Under Influence of Androgens) Terminal hair follicles are transformed into vellus. Shortened anagen and an increased telogen. Decreased growth of hair on the scalp as well as axilla

3 Finpecia Role of DHT T converted to DHT with the help of 5 -reductase. Persons with an inherited deficiency of type II 5 -reductase & castrated prepubertal boys or eunuchs do not develop androgenic alopecia Under the influence of DHT, the terminal follicle is converted to a vellus follicle High concentrations of DHT seen in the scalp of patients with androgenic alopecia.

4 Finpecia Finasteride - Effects on semen production No effect since; Testosterone is responsible for spermatogenesis Men with an inherited deficiency of 5 -reductase still have normal sperm development.

5 Finpecia Pharmacokinetic properties of oral finasteride after repeated administration of 1 mg/day or after single dose of 5 mg. 1mg/day5 mg (n=12)(n=6) Day 1Day 17 C max ( g/L) t max (h) t ½ (h) AUC 0-24 ( g/L/h)

6 Finpecia Finasteride - 1mg Clinical Efficacy Evaluated in three phase III placebo-controlled studies, each of 1 years duration Additionally, the two studies in men with mild to moderate vertex hair loss continued in a blinded manner for a second year. A total of 1879 male patients aged between 18 and 41 years were enrolled in the trials. A wide spectrum of patients (vertex and frontal hair loss) were enrolled in the study.

7 Finpecia Finasteride 1 Mg: In Frontal Male Pattern Hair Loss Double-blind placebo-controlled trial (n = 326). End points included hair counts in the frontal scalp, patient self-assessment, investigator assessment and evaluation of global photographs. Finasteride 1 mg significantly increased scalp hair counts in the frontal area (P<0.001). Cosmetic improvement was noted by patients, investigators and global reviewers. Aust J Dermatol 1997; 38 (Suppl.2 ) 101-2

8 Finpecia Finasteride-1 Mg – Tolerability Not significantly different from that of placebo except for sexual functional disorders Sexual adverse events were reported in (3.8%) finasteride compared with (2.1%) placebo recipients and comprised decreased libido (1.8 vs. 1.3%), ejaculation disorders (1.2 vs. 0.7%) and erectile dysfunction (1.3 vs. 0.7%) Resolved in many patients who reported them but remained on therapy. It also resolved in those who stopped therapy. Small reductions (from 0.7 to 0.5 ng/ml) in serum prostate-specific antigen (PSA) may be seen. Hence double the reported PSA before interpreting.

9 Finpecia Finasteride 1mg - Indications Treatment of men with male pattern hair loss and to prevent further hair loss in these patients.

10 Finpecia Finasteride-1mg - Dosage & Administration 1mg/day taken with or without food. Continue for at least 3 months before assessing. Effects are reversed within 12 months of stopping therapy Dosage adjustment unnecessary in elderly or in renal insufficiency. Contraindicated in women.

11 Finpecia BaselineMonth 12Month 24 J Am Acad Dermatol 1998; 39: Patient 1

12 Finpecia Hair count mean change from baseline (± SE) from the combined US and international studies for men who entered the extension studies. J Am Acad Dermatol 1998; 39: Baseline Month Fin Þ Pbo Fin Þ Fin Pbo Þ Pbo Þ Mean Hair Count Change from Baseline = 1 SE

13 Finpecia J Am Acad Dermatol 1998; 39: Investigator assessment mean rating score (+ 1 SE) from the combined US and international studies for men who entered the extension studies.

14 Finpecia Drugs 1999; 57(1): Treatment-related sexual adverse events reported with finasteride. Men with male pattern hair loss were randomised to receive oral finasteride 1 mg/day (n=945) or placebo (n=934) for 1 year. * p = vs. placebo Placebo Finasteride Incidence (% of patients) TotalDecreased libido Ejaculation disorders Erectile dysfunction

15 Finpecia Finasteride in frontal hair loss Hair count mean change from baseline (+ 1 SE). 12 Month All patients 1 mg M e a n C h a n g e f r o m B a s e l i n e S. E ( H a i r s ) + Baseline J Am Acad Dermatol 1999; 40: