Five‐year efficacy of finasteride in 801 Japanese men with androgenetic alopecia
Five‐year efficacy of finasteride in 801 Japanese men with androgenetic alopecia
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DOI：
10.1111/1346-8138.12890
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发表时间：
2015-07
期刊：
影响因子：
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通讯作者：
T. Yoshitake;A. Takeda;Kensaku Ohki;Y. Inoue;T. Yamawaki;Saori Otsuka;Minekatsu Akimoto;M. Nemoto-M.-N
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文献类型：
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作者：
T. Yoshitake;A. Takeda;Kensaku Ohki;Y. Inoue;T. Yamawaki;Saori Otsuka;Minekatsu Akimoto;M. Nemoto-M.-N
非那雄胺是雄激素性脱发的标准药物治疗；然而，在日本没有进行过为期5年或更长时间的大型随访研究。作者对接受非那雄胺治疗的日本男性雄激素性脱发患者进行了为期5年的随访，以评估长期治疗效果。903名接受非那雄胺（1mg /天）治疗的男性中，801名患者在5年内通过改良的全球摄影评估进行了评估。虽然改善的比例很高（99.4%），但根据改进的Norwood-Hamilton量表，在疾病较晚期的患者中，治疗5年后的改良总体摄影评估评分较低。根据5年后改良的全局摄影评估评分（评分分别为≥6分和<6分）将患者分为“充分”和“不足”两组，多因素分析显示，疗效不足的独立危险因素为治疗开始时年龄≥40岁（P = 0.021）和改良的Norwood-Hamilton量表分类（P < 0.001），而治疗开始时存在压力是负向预测因素（P = 0.025）。结论：在日本患者中，持续使用非那雄胺治疗5年可改善雄激素性脱发，且疗效持续。治疗开始时年龄较年轻和病情较轻是非那雄胺疗效较高的关键预测因素。
Finasteride is standard medical treatment for androgenetic alopecia; however, no large studies with 5 years or more of follow up have been performed in Japan. The authors followed Japanese men with androgenetic alopecia treated with finasteride for 5 years to evaluate long‐term treatment efficacy. Of 903 men treated with finasteride (1 mg/day), 801 patients were evaluated over 5 years by modified global photographic assessment. Although the proportion of improvement was high (99.4%), modified global photographic assessment scores after 5 years of treatment were lower in patients with more advanced disease as measured by the modified Norwood–Hamilton scale. After separating patients into “sufficient” and “insufficient” efficacy groups according to the modified global photographic assessment score after 5 years (scores ≥6 and <6, respectively), multivariate analysis showed that independent risk factors of insufficient efficacy were age at start of treatment of 40 years or more (P = 0.021) and classification on the modified Norwood–Hamilton scale (P < 0.001), whereas presence of stress at start of treatment was a negative predictor (P = 0.025). In conclusion, continuous finasteride treatment for 5 years improved androgenetic alopecia with sustained effect among Japanese. Younger age and less advanced disease at start of treatment were the key predictors of higher finasteride efficacy.