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

After FDA approved finasteride for male hair loss in 1997, the drug’s reputation stayed untarnished for a dozen years in the United States. However, the tide shifted in the 2010s: label warnings were added about risks of depression and lasting sexual dysfunction. Lawsuits about persistent sexual dysfunction were filed against Merck. These were later consolidated … 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.

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.

Mind the gaps: remarks on the evidence base

This post makes a few not-so-obvious points about the sprawling literature on finasteride and 5-alpha syndrome. If you are new to this literature, consider starting with a brief history of the research and a guide for researchers. Those pages describe what is in the literature, but it is also important to discern what is not … Read more

Response to Dr. Ralph Trüeb’s writings on post-finasteride syndrome

A drug-induced syndrome is all in the mind, a Swiss doctor wrote. Editors of the journals had past ties to the drug maker.

Appendix: response to Trüeb

This appendix accompanies the article: Response to Dr. Ralph Trüeb’s writings on post-finasteride syndrome. Table of competing interests ← back to main article Engagements with Merck re: Propecia Skin Appendage Disorders (journal) (1) International Journal of Trichology (2) Experimental Dermatology (journal) Hair Growth and Disorders textbook (2008) Cited by Trüeb Ralph Trüeb, MD Member, Editorial … Read more

From the depths: why finasteride harms took decades to emerge

Physician-researchers blamed growing safety concerns on patients, overlooking social context and weaknesses in safety regime The official view of Propecia, fashioned by Merck at a reported cost of $450 million, is that the drug is safe and effective. Upon approval by FDA in 1997, this view was carried forward by dermatologists, some of whom were … Read more

Tapped by Merck for litigation defense, a physician-researcher sowed doubts about finasteride harms

A 2018 article disclosed that Dr. Kevin McVary had been retained as an expert for Merck’s defense in litigation regarding persistent adverse effects (AEs) of finasteride.1 Dr. McVary has also been relatively active as a contributor of three conference abstracts, an original article, an expert review, a quote in a media story and a symposium presentation … Read more