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Evidence summaries

Flutamide for Hirsutism

Flutamide appears to be effective for hirsutism compared with placebo and may as effective as spironolactone. Level of evidence: "B"

Comment: The quality of evidence is downgraded by study quality and by imprecise results (few patients).

Summary

A Cochrane review [Abstract] 1 assessed different medical treatments for hirsutism. Flutamide 250 mg b.i.d. was more effective than placebo in reducing Ferriman-Gallwey scores (score 0 to 36) (MD -7.60, 95% CI -10.53 to -4.67 in one and MD -7.20, 95% CI -10.15 to -4.25 in the other study). Spironolactone showed similar effectiveness to flutamide in 2 studies (MD -1.90, 95% CI -5.01 to 1.21 and MD 0.49, 95% CI -1.99 to 2.97). There was no clear difference compared to metformin in 3 studies, but the results were inconsistent.

A meta-analysis 2 assessing treatment options for hirsutism included 43 trials. Antiandrogen monotherapy with flutamide, finasteride, and spironolactone were each superior to placebo but similar to each other in efficacy.

Clinical comments

Note

Date of latest search: 11 June 2014

    References

    • van Zuuren EJ, Fedorowicz Z, Carter B et al. Interventions for hirsutism (excluding laser and photoepilation therapy alone). Cochrane Database Syst Rev 2015;(4):CD010334. [PubMed]
    • Barrionuevo P, Nabhan M, Altayar O et al. Treatment Options for Hirsutism: A Systematic Review and Network Meta-Analysis. J Clin Endocrinol Metab 2018;103(4):1258-1264. [PubMed]

Primary/Secondary Keywords