OUTCOME OF LONG-TERM TREATMENT WITH THE 5-ALPHA-REDUCTASE INHIBITOR FINASTERIDE IN IDIOPATHIC HIRSUTISM - CLINICAL AND HORMONAL EFFECTS DURING A 1-YEAR COURSE OF THERAPY AND 1-YEAR FOLLOW-UP

Objective: To evaluate the long-term efficacy of the 5 alpha-reductase inhibitor finasteride in idiopathic hirsutism. Design: Prospective cl inical study. Setting: Out-patients in a university hospital. Patient( s): Fourteen young women with idiopathic hirsutism. Intervention(s): F inasteride, 5 mg once daily, was given for 12 months. Main Outcome Mea sure(s): Degree of hirsutism, graded by a modified Ferriman and Gallwe y score, serum sex hormones, and serum and urinary markers of 5 alpha- reductase activity. Clinical outcome was evaluated up to and including the 1-year post-treatment period, Result(s): The Ferriman and Gallwey score showed a remarkable reduction after 12 months of finasteride tr eatment (4.4 +/- 0.7 versus 11.8 +/- 1.0; mean +/- SEM). Serum levels of the two Scr-reductase activity markers, dihydrotestosterone and 3 a lpha-androstanediol glucuronide, decreased, and urinary C19 and C21 5 beta:5 alpha steroid metabolite ratios consistently increased during f inasteride administration. These changes were reversed readily after c essation of treatment. No significant adverse effect was reported. Nin e of 14 women completed the 1-year post-treatment follow-up. Their hir sutism scores were increased substantially as compared with values rec orded at the end of therapy, but still were lower than baseline values . Conclusion(s): The 5 alpha-reductase inhibitor finasteride is effect ive and well tolerated in longterm treatment of women with idiopathic hirsutism. Post-treatment follow-up suggests that drug effects on hair growth are sustained in the majority of subjects with this disorder.