Thu, 21 Aug 2008 04:50:30 BST CiteULike: omalbams Erwin http://www.citeulike.org/user/omalbam/author/Erwin CiteULike.org en-gb Copyright © 2004-2008 citeulike.org http://www.citeulike.org/user/omalbam/article/2697227 <i>J Clin Endocrinol Metab, Vol. 93, No. 4. (1 April 2008), pp. 1153-1160.</i><br /><br />Context: The relative efficacy of antiandrogens for the treatment of hirsutism remains unclear. Objective: We performed a systematic review and metaanalyses of randomized controlled trials (RCTs) evaluating the effect of antiandrogens on hirsutism. Data Sources: We used librarian-designed search strategies for MEDLINE, EMBASE, and Cochrane CENTRAL (up to May 2006), review of reference lists, and contact with hirsutism experts to identify eligible RCTs. Study Selection: Eligible studies were RCTs of at least 6 months of antiandrogen use in women with hirsutism. Reviewers, with acceptable chance-adjusted agreement (kappa = 0.72), independently assessed eligibility. Data Extraction: Reviewers used structured forms to assess and collect methodological quality (allocation concealment, blinding, and loss to follow-up) and study data. Data Synthesis: Of 348 candidate studies, 12 were eligible (18 comparisons). Their methodological quality was low. Random-effects metaanalyses showed that compared with placebo, antiandrogens reduce Ferriman-Gallwey scores by 3.9 [95% confidence interval (CI), 2.35.4; inconsistency (I2) = 0%]. When compared with metformin, spironolactone reduced hirsutism scores by 1.3 (CI, 0.032.6) and flutamide by 5.0 (CI, 3.07.0; I2 = 0%). For these interventions, two to five women need to receive treatment for one to notice improvement. Spironolactone or finasteride in combination with contraceptives (1.7; CI, 0.13.3; I2 = 0%) or flutamide with metformin (4.6; CI, 1.37.9; I2 = 40%) appear superior to monotherapy with contraceptives and metformin, respectively. Only three RCTs reported patient self-assessments of hirsutism. Conclusions: Weak evidence suggests antiandrogens are mildly effective agents for the treatment of hirsutism. 10.1210/jc.2007-2430 Antiandrogens for the Treatment of Hirsutism: A Systematic Review and Metaanalyses of Randomized Controlled Trials Brian Swiglo Mihaela Cosma David Flynn David Kurtz Matthew Labella Rebecca Mullan Patricia Erwin Victor Montori doi:10.1210/jc.2007-2430 J Clin Endocrinol Metab, Vol. 93, No. 4. (1 April 2008), pp. 1153-1160. 2008-04-21T17:04:06-00:00 2008 J Clin Endocrinol Metab 93 4 1153 1160 hirsutism meta-analysis therapy