title: Prospective cohort study on the effects and tolerability of flutamide in patients with female pattern hair loss.
abstract: BACKGROUND
  Flutamide has been rarely used for the treatment of female pattern hair loss (FPHL). Flutamide treatment for FPHL has not been evaluated in long-term studies with sufficiently large numbers of women.
  
  
  OBJECTIVE
  To evaluate long-term effects, safety, and tolerability of flutamide in women with FPHL.
  
  
  METHODS
  A prospective cohort study was conducted in our tertiary care university hospital. The cohort included 101 women diagnosed with FPHL from January 1991 to January 2006. These women received yearly reducing doses (250, 125, and 62.5 mg/day) of flutamide for 4 years. The cohort included 33 patients treated with flutamide alone and 68 treated with flutamide combined with an oral contraceptive. Clinical and endocrine evaluations were assessed semiannually and annually, respectively, in the first 3 years of the study, and once in the following year. Liver function was evaluated quarterly.
  
  
  RESULTS
  Both groups showed a marked decrease in alopecia scores after 12 months of flutamide therapy, compared with baseline values. The maximum drug effect occurred after 2 years and was maintained during the following 2 years of treatment. Androgens were strongly suppressed. During the first year of treatment, 4% of patients abandoned the study due to hepatic disorders related to the drug. During the following years, with the lower treatment regimen, no patient abandoned the study because of hepatic alterations.
  
  
  CONCLUSIONS
  Flutamide is a satisfactory therapeutic regimen for treatment of FPHL in the long run. Moreover, the use of very low doses (62.5 mg/day) of flutamide is associated with complete hepatic tolerability and high adherence.
authors.affiliation: Department of Gynecology and Reproductive Biology, S. Orsola Hospital, University of Bologna, Bologna, Italy. roberto.paradisi@unibo.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Paradisi
authors.forename: Eleonora
authors.initials: E
authors.lastname: Porcu
authors.forename: Raffaella
authors.initials: R
authors.lastname: Fabbri
authors.forename: Renato
authors.initials: R
authors.lastname: Seracchioli
authors.forename: Cesare
authors.initials: C
authors.lastname: Battaglia
authors.forename: Stefano
authors.initials: S
authors.lastname: Venturoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000505:Alopecia / Q000188:drug therapy*; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D003276:Contraceptives, Oral / Q000627:therapeutic use; D005260:Female; D005485:Flutamide / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D008111:Liver Function Tests; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000726:Androgen Antagonists; D003276:Contraceptives, Oral; D005485:Flutamide