Recent studies of adverse events

A wave of studies of adverse event reports link finasteride to sexual disorders as well as cognitive dysfunction. The field of pharmacovigilance assess the effects of drugs as they are used in the real world. Researchers often use adverse event (AE) data from FDA’s FAERS database or the World Health Organization’s EudraVigilance database. The records, … Read more

Merck’s former physician-allies sowed doubt while Propecia litigation was pending

In a burst of output in the late 2010s, key opinion leaders stressed that a causal role for the drug couldn’t be proved—a welcome message for Merck’s litigation defense After FDA approved finasteride for male hair loss in 1997, the drug’s reputation stayed unblemished for a dozen years in the United States. However, the tide … Read more

The most far-fetched theories of post-finasteride syndrome

The two most far-fetched theories of post-finasteride syndrome were proposed by a dermatologist and a hair transplant surgeon. Physicians in these specialties tend to fervently deny that the syndrome is a valid medical condition, pointing instead to co-occurring conditions such as diabetes, anxiety, depression or, according to the theories below, delusions or sleep apnea. Theory … Read more

Medical journals and physicians ignore conflicts of interest after a few years

Physician-researchers known as key opinion leaders have a crucial role in launching a drug into the marketplace. While Propecia litigation was underway in the 2010s, a number of opinion leaders who had helped Merck launch Proscar and Propecia wrote articles defending the drug’s safety.

New bibliography of case reports and series

A new bibliography of case reports & series is available. The papers come from a wide range of medical specialties including dermatology, hematology, hepatology, neurology, ophthalmology, pediatrics and andrology. Most were already in the main bibliography, but a few new ones were discovered. View the new bibliography: Case reports & series

Reckoning with underreporting—response to Lauck et al, 2024

We do not know if the medical records used in this study are sensitive to sexual dysfunction in healthy men, and especially in men taking these drugs for hair loss. Since the study includes men taking 5-ARIs, the results do not shed light on why sexual dysfunction might persist after stopping these drugs.

Study of depression from prostate drugs loses the signal by including past users

This study fails to assess the risk of depression associated with using finasteride or dutasteride because past users of 5-ARIs were counted as cases. 37% of cases in the 5-ARI group had stopped taking the drug 181 days or more prior to initial diagnosis or treatment for depression. Only slightly more than half of cases were current users at the time of initial diagnosis or treatment for depression. Moreover, the control group was taking ⍺-blockers.

Study of ED risk loses the signal by including past users of finasteride

There is a major limitation: the analysis included past and recent users of 5ARIs, as well as current users. Past users are defined as those who stopped taking a 5ARI at least 91 days before getting diagnosed or treated for ED. Recent users are those who last took the drug 31-90 days before diagnosis or treatment for ED.