A comparison of the relative efficacy of antiandrogens for the treatment of acne in hyperandrogenic women.
OBJECTIVE
To compare the relative effectiveness of two newer antiandrogens (flutamide and finasteride) with cyproterone acetate (CPA), at both low and high doses in the treatment of moderate to severe acne in hyperandrogenic women.


METHODS
Forty-eight hyperandrogenic women were prospectively randomized to the following treatments for 1 year: CPA 2 mg with 35 micro g ethinylestradiol; CPA 50 mg with 25 micro g ethinylestradiol (reverse sequential regimen); flutamide 250 mg daily; and finasteride 5 mg daily. Assessment of Cook scores was the primary end-point of the trial. Blood for androgens was obtained at baseline in these women and 30 ovulatory age-matched controls.


RESULTS
Serum androgens were elevated in all 48 women and was similar in each of the four treatment groups. Cook scores were significantly and equally decreased (59-71%) with flutamide and both low and high doses of CPA (P < 0.01). The decrease with finasteride (-36 +/- 2%) was statistically significant but lower than that obtained with the other agents. All treatments were well tolerated.


CONCLUSIONS
In hyperandrogenic women with moderate to severe acne, low doses of certain antiandrogens appear to be effective. Low and high doses of CPA with ethinylestradiol were equally effective and were comparable to the effects of a low dose of flutamide. Finasteride was less beneficial.
Carmina
Enrico
E
Department of Endocrinology, University of Palermo, Palermo, Italy.
Lobo
Rogerio A
RA
D000152:Acne Vulgaris / Q000188:drug therapy*; D000328:Adult; D000726:Androgen Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use; D017373:Cyproterone Acetate / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D018120:Finasteride / Q000627:therapeutic use; D005485:Flutamide / Q000627:therapeutic use; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications* / Q000188:drug therapy; D011446:Prospective Studies; D018709:Statistics, Nonparametric
D000726:Androgen Antagonists; D017373:Cyproterone Acetate; D018120:Finasteride; D005485:Flutamide