KD Kaufman

Contents

18.1 Role of 5a-reductase in androgen physiology and pathophysiology

18.1.1 Normal androgen metabolism

18.1.2 Evidence for role of 5a-reductase in pathophysiology of androgen disorders 18.1.2.1 Genetic 5a-reductase deficiency

18.2 Rationale for and development of 5a-reductase inhibitors

18.3 Early studies with finasteride, a type 2 5a-reductase inhibitor

18.3.1 Effects on serum androgens and gonadotropins

18.3.2 Effects on other hormones

18.3.3 Effects on hematologic parameters

18.4 Clinical studies with finasteride in men with benign prostatic hyperplasia

18.4.1 Efficacy based on prostate volume and symptoms

18.4.2 Long-term effects on disease progression

18.4.3 Safety

18.5 Clinical studies with finasteride in men with androgenetic alopecia

18.5.1 Efficacy based on hair count, hair weight, clinical photography, patient assessment

18.5.2 Study in monozygotic twins

18.5.3 Long-term follow-up

18.5.4 Safety

18.6 Safety studies with finasteride in men

18.6.1 Effects on bone

18.6.2 Effects on semen

18.6.3 Effects on lipids

18.7 Clinical studies with finasteride in women

18.7.1 Study in postmenopausal women with androgenetic alopecia

18.7.2 Studies in women with hirsutism

18.8 Preliminary studies with MK-386, a type 1 5a-reductase inhibitor 18.8.1 Effects on serum and sebum DHT

18.8.1.1 Effects in combination with finasteride

18.9 Future research

18.9.1 Long-term study of finasteride in chemoprevention of prostate cancer

18.9.2 Development of other 5a-reductase inhibitors

18.10 Key messages

18.11 References

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