Comment: The quality of evidence is downgraded by study quality and by imprecise results (few patients).
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.
Date of latest search: 11 June 2014
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