Relative Efficacy of Minoxidil and the 5-? Reductase Inhibitors in Androgenetic Alopecia Treatment of Male PatientsA Network Meta-analysis

Aditya K. Gupta, MD, PhD^1,2; Maanasa Venkataraman, MSc¹; Mesbah Talukder, PhD¹; et alMary A. Bamimore, PhD¹

JAMA Dermatol. Published online February 2, 2022. doi:10.1001/jamadermatol.2021.5743

Key PointsQuestion For male androgenetic alopecia, what is the relative efficacy of monotherapy with orally and topically administered minoxidil, dutasteride, and finasteride?

Findings In this network meta-analysis of 23 trials, the rank of efficacy across treatments and the relative efficacy for every possible pairwise comparison of treatments were determined for 4 end points (ie, change in total and terminal hair count after 24 and 48 weeks). The results of this meta-analysis indicate that 0.5 mg/d of oral dutasteride has the highest probability of being the most efficacious treatment, followed by these agents in decreasing order of efficacy: 5 mg/d of oral finasteride, 5 mg/d of oral minoxidil, 1 mg/d of oral finasteride, 5% topical minoxidil, 2% topical minoxidil, and 0.25 mg/d of oral minoxidil.

Meaning The findings of this meta-analysis contribute to the comparative effectiveness literature for AGA therapies with regard to the compared interventions.