The efficacy and safety of dutasteride compared with finasteride in treating men with androgenetic alopecia: a systematic review and meta-analysis

Aim: We performed a meta-analysis to evaluate the efficacy and safety of dutasteride and finasteride in treating men with androgenetic alopecia (AGA) during a 24-week treatment cycle. Methods: Randomized controlled trials of dutasteride and finasteride for treating AGA were searched using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The data were calculated using Rev Man v5.3.0. The reference lists of retrieved studies were also investigated. Results: Three articles including 576 participants which compared dutasteride with finasteride were selected for our analysis. The mean change in total hair count (mean difference [MD], 28.57; 95% CI, 18.75-38.39; P<0.00001), investigator's assessment of global photographs for the vertex (MD, 0.68; 95% CI, 0.13-1.23; P=0.02) and frontal (MD, 0.63; 95% CI, 0.13-1.13; P=0.01) views, panel global photographic assessment for the vertex (MD, 0.17; 95% CI, 0.09-0.24; P<0.00001) and frontal (MD, 0.25; 95% CI, 0.18-0.31; P<0.00001) views, and subjects' assessment (MD, 0.56; 95% CI, 0.18-0.94; P=0.003) suggested that dutasteride provided a better efficacy in treating men with AGA compared with finasteride. With regard to the assessment of safety, altered libido (P=0.54), erectile dysfunction (P=0.07), and ejaculation disorders (P=0.58), dutasteride did not show a significant difference compared with finasteride. Conclusion: Dutasteride seems to provide a better efficacy compared with finasteride in treating AGA. The two drugs appear to show similar rates of adverse reactions, especially in sexual dysfunction.