Georgetown Health Care Center
The Food and Drug Administration is reviewing finasteride data for the treatment of male-pattern baldness. Finasteride, an oral agent, is on the market in a 5mg/day formulation for the treatment of benign prostatic hyperplasia (BPH).
As reported in Internal Medicine News (March 15, 1997) results from a phase II study that compared 74 men who received a 5mg/day dosage of finasteride with 80 men who received a placebo found that those treated with finasteride had a significant increase in vertex hair during 12 months of treatment. Those treated had a mean increase of approximately 100 hairs in a 1-inch circle on their vertex, compared with a slight decline in mean hair number among those who received placebo. The investigators judged that more than 50% of the finasteride-treated men had moderately or greatly increased hair growth.
The apparent success of finasteride in treating male-pattern hair loss is the inhibition of 5a-reductase, the enzyme that converts testosterone to dihydrotestosterone (DHT). It is DHT that is responsible for male-pattern baldness, prostate enlargement, and male acne. A 5mg/day dose of finasteride decreases DHT levels by about 70%.
Approximately four percent of older men using finasteride at the 5mg/day dosage for BPH developed impotence. The incidence is lower, however, in younger men.
A new Provider Recognition Program has been created by the American Diabetes Association and cosponsored by the National Committee for Quality ASsurance. Physicians that measure up on 11 standards of diabetes care can qualify, and those recognized will be publicized through Web sites and other methods. The 11 performance indicators are (1) hemoglobin A1C measurement, (2) eye exam, (3) foot exam, (4) blood pressure measurement, (5) urine protein measurement, (6) lipid profile, (7) education in Diabetes self-management, (8) medical nutrition therapy, (9) self-monitoring of blood glucose, (10) tobacco status and counseling referral, and (11) patient satisfaction.
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