14 May Hair Loss: Sexual Dysfunction Signal Linked To Finasteride Use Young Men
MedicalResearch.com Interview with:
Naeem Bhojani, MD, FRCSC
Division of Urology,
Centre Hospitalier de l’Université de Montréal (CHUM),
University of Montréal, Montréal, Québec, Canada
David-Dan Nguyen MPH
Division of Urological Surgery and
Center for Surgery and Public Health,
Brigham and Women’s Hospital, Harvard Medical School,
Boston, MassachusettsFaculty of Medicine and Health Sciences,
McGill University, Montréal, Québec, Canada
MedicalResearch.com: What is the background for this study?
Response: In a recent study by our group published in JAMA Dermatology (https://jamanetwork.com/journals/jamadermatology/fullarticle/2772818), finasteride use was found to be associated with increased reporting of suicidality and depression in young patients with androgenetic alopecia.
This previous analysis suggested that the association between finasteride and depression might be mediated by sexual dysfunction. Building on this work, we conducted this second analysis to examine the association between finasteride use and reports of sexual dysfunction.
MedicalResearch.com: What are the main findings?
Response: We conducted a pharmacovigilance analysis of VigiBase, the World Health Organization’s international database of individual case safety reports, from inception to 2019. It is the largest database of its kind. A strength of this approach is the possibility of conducting comprehensive subgroup analyses to further explore various hypotheses. We detected disproportional signals of sexual dysfunction linked with finasteride use.
Despite sexual dysfunction being more prevalent in older BPH patients, we detected larger signals of sexual dysfunction in young alopecia patients. Sensitivity analyses suggest that reports of sexual dysfunction linked with finasteride use may be confounded by indication (young alopecia patients may be more likely to experience sexual dysfunction) and by stimulated reporting. However, stimulated reporting alone does not account for the totality of the signal observed in young patients with alopecia considering the large difference in signal size between finasteride and minoxidil.
MedicalResearch.com: What should readers take away from your report?
Response: Our findings further support the evidence of sexual dysfunction linked with finasteride use, especially in younger alopecia patients. While we observed stimulated reporting, it is unlikely that stimulated reporting alone accounts for the entirety of the effect. Further studies are needed to understand if this side effect of finasteride is a mediator of the association between finasteride use and psychological adverse events.
MedicalResearch.com: What should readers take away from your report? What recommendations do you have for future research as a result of this work?
Response: Our findings further support the evidence of sexual dysfunction linked with finasteride use, especially in younger alopecia patients. While we observed stimulated reporting, it is unlikely that stimulated reporting alone accounts for the entirety of the effect. Further studies are needed to understand if this side effect of finasteride is a mediator of the association between finasteride use and psychological adverse events.
Limitations and Disclosures: Our findings are not without limitations. We have extensively detailed the limitations of our work which should be taken into account when interpreting the findings of our study.
Our disclosures are included in the manuscript. We do not have any directly relevant conflicts of interest.
Citation:
Disproportional signal of sexual dysfunction reports associated with finasteride use in young men with androgenetic alopecia: A pharmacovigilance analysis of VigiBase
Nguyen, David-Dan et al.
Journal of the American Academy of Dermatology, Volume 0, Issue 0
https://www.jaad.org/article/S0190-9622(22)00527-8/fulltext#%20
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Last Updated on May 14, 2022 by Marie Benz MD FAAD