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February 2003

Flutamide Shows Promise as Treatment for Alopecia in Women

By Alison McCook

NEW YORK (Reuters Health) Feb 10 -

Women with hyperandrogenic alopecia may benefit from treatment with flutamide, findings from a small study suggest.

In a trial involving 48 women with alopecia, more women who took flutamide for 1 year said their hair regrew, had stopped thinning and had improved in overall appearance than did those who received other agents or no treatment at all.

However, study author Dr. Rogerio Lobo, from Columbia University in New York, cautioned that the improvement women saw with flutamide "was not dramatic."

"The improvement I would classify as being 'moderate'," Dr. Lobo told Reuters Health.

Trials of treatments that block androgens to help prevent hair loss in women "have been generally unsuccessful," Dr. Lobo and coauthor Dr. Enrico Carmina write in the January issue of Fertility and Sterility.

In the current study, flutamide was compared with cyproterone acetate and finasteride (Propecia). All of the women were premenopausal and had hyperandrogenic alopecia. Twelve women were assigned to receive each one of the three treatments, and another 12 underwent no treatment for 1 year.

At 1 year, eight women taking flutamide said their rate of hair loss had decreased, relative to only three given cyproterone acetate and one who received finasteride. In addition, patients taking flutamide were more satisfied with their treatment and were more likely to report an improvement in hair regrowth and appearance.

The researchers limited the dose of flutamide to 250 milligrams per day because the drug has been linked to liver damage. Indeed, 2 of the 12 women who received flutamide experienced a mild, reversible increase in liver enzymes, the authors note.

All patients treated with flutamide "need close monitoring for liver function," Dr. Lobo told Reuters Health.

For some women who are losing hair, flutamide might now represent a treatment option, the researcher noted. "Some but not all women would be eligible to try flutamide if they have been fully evaluated, have a significant problem, and if nothing in the past has helped," Dr. Lobo said.