Higher doses of oral dutasteride yield best results in frontal fibrosing alopecia

Patients with frontal brosing alopecia who received higher doses of oral dutasteride experienced the greatest improvement in hairline recession, according to a study.

“Dutasteride has been proposed as an effective therapy for frontal brosing alopecia (FFA),” Cristina Pindado-Ortega, MD, of the department of dermatology at University Hospital Ramón y Cajal, Madrid, and colleagues wrote.

In the retrospective observational study, the researchers aimed to define therapeutic responses to dutasteride as assessed by stabilization of hairline recession and determine dosing rates for FFA. They also compared the drug with other therapies or no treatment.

The analysis included 224 patients, of which 222 were women.

The minimum follow-up duration for patients in this study was 12 months, while the median follow-up was 24 months.

Among 148 patients treated with dutasteride for 12 months, the stabilization rate for the frontal region was 62%, which was comparable to the 64% rate for the right region and 62% for the left. By comparison, among 20 patients treated with other systemic therapies, 12-month stabilization rates were 60% for the front, 35% for the right and 35% for the left. For 56 patients who received no systemic therapy, stabilization rates were 30% for the front, 41% for the right and 38% for the left.

The researchers also aimed to assess different dosing levels of dutasteride in FFA. Patients received one or two 0.5 mg capsules of the drug per week, three 0.5 mg capsules per week, or five to seven 0.5 mg capsules per week. The highest stabilization rates were found in the 32 patients who received the highest doses, at 87.5% for the front, 90.6% for the right and 84.4% for the left.

Adverse events occurred in two patients in the dutasteride group and resolved when the drug was withdrawn.

The researchers noted that the study was limited by its observational and retrospective design. They concluded that the “real clinical practice” data set showed dose-dependent efficacy of dutasteride in FFA.