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Insufficient evidence that finasteride is safe to use for male pattern baldness

The study

It aimed to explore the quality of safety reporting for clinical trials reports on finasteride for androgenic alopecia. Factors assessed included quality, number and type of adverse event reporting, and duration of safety evaluation.

The findings

1 Of 34 clinical trials assessed, none had adequate safety reporting – 19 were partially adequate, 12 were inadequate and three reported no adverse events.

2 More than half of the trials received funding from the manufacturer.

3 Duration of safety evaluation was less than one year in 76% of the trials.

What does this mean for GPs?

Evidence on adverse effects of finasteride for alopecia is limited, systematically biased and of poor quality.

There is insufficient data to ascertain the safety of finasteride for the treatment of male pattern baldness.

Doctors should consider this when discussing the potential risks of finasteride with patients.

The paper

JAMA Dermatology April 2015

Dr Hamed Khan is a GP in the emergency department of St George’s, London, and a clinical lecturer. He tweets as @drhamedkhan.