COMPARISON OF FLUTAMIDE AND CYPROTERONE-ACETATE IN THE TREATMENT OF HIRSUTISM - A RANDOMIZED CONTROLLED TRIAL

The objective of this study was to compare the efficacy of flutamide a nd cyproterone acetate in rite treatment of hirsutism. Twenty-two wome n with idiopathic hirsutism were randomized to receive either flutamid e or cyproterone acetate. Each patient underwent a complete gynecologi cal examination as well as an endocrinological profile and hematologic al, hepatic and renal function analyses. Hirsutism scores there determ ined using a modified Ferriman-Gallwey scoring system. These rests wer e then repeated at 3 and 9 months of therapy. Eleven patients received 250 mg of flutamide twice daily and 11 patients received 100 mg of cy proterone acetate on days 5-14 of the menstrual cycle. Ferriman-Gallwe y scores were decreased significantly in both groups at the end of 9 m onths. There was a trend towards a better response with flutamide, tha t did not achieve significance. Another significant difference was the increased sex hormone-binding globulin in both groups. A statisticall y significant decrease was also observed for the levels of testosteron e on both drugs. No subject withdrew from the study due to a side-effe ct. The data suggest that both flutamide and cyproterone acetate were similarly effective in treatment of hirsutism, and that the pure antia ndrogen flutamide is a safe, well-tolerated and effective alternative in treatment.