COMPARISON OF CYPROTERONE-ACETATE PLUS ETHINYL ESTRADIOL AND FINASTERIDE IN THE TREATMENT OF HIRSUTISM

The aim of this study was to compare the clinical efficacy and safety of low dose cyproterone acetate-estrogen combination (Diane(R)) and th e 5 alpha-reductase inhibitor finasteride in the treatment of hirsutis m. Fourty-two women with hirsutism were included in the study. Twenty- one patients treated with cyproterone acetate (CPA) 2 mg and ethinyl e stradiol (E) 35 mu g daily on days 5-25 of the menstrual cycle, 21 wit h finasteride 5 mg daily. Hirsutism score, hormone levels, multiscreen blood chemistry and side effects were evaluated at three-monthly inte rvals for 9 months. A significant decrease in hirsutism score as compa red to baseline was observed after 9 months with either CPA+E (Diane(R )) (mean +/- SE, 15.81+/-1.19 vs 8.38+/-1.21) or finasteride treatment (17.81+/-1.05 vs 10.86+/-0.91) (p<0.0005). The reductions in hirsutis m scores (mean% +/- SE) were 14.23+/-2.29 vs 19.77+/-2.22 (p<0.05) at 3, 40.23+/-4.58 vs 29.49+/-2.69 (p<0.02) at 6 and 50.99+/-4.13 vs 39.8 7+/-3.30 (p<0.02) at 9 months in CPA+E and finasteride groups, respect ively. No significant changes were observed in hormone levels during f inasteride treatment. Serum free testosterone significantly decreased at the third month of treatment, and remained suppressed for the durat ion of treatment in CPA+E group. DHEAS levels also decreased significa ntly after 6 and 9 months of therapy with CPA+E. SHBG significantly in creased during CPA+E treatment. We conclude that both drugs are effect ive and well tolerated, but CPA+E appears to be more effective than 5a -reductase inhibitor finasteride in long-term treatment of hirsute wom en. Diane(R) is also a cost-effective drug. (J. Endocrinol. Invest. 21 : 348-352, 1998) (C)1998, Editrice Kurtis.