Abstract:
Importance:There is ongoing controversy about the adverse events of finasteride, a drug used in the management of alopecia and benign prostatic hyperplasia (BPH). In 2012, reports started emerging on men who had used finasteride and either attempted or completed suicide. Objective:To investigate the association of suicidality (ideation, attempt, and completed suicide) and psychological adverse events (depression and anxiety) with finasteride use. Design, Setting, and Participants:This pharmacovigilance case-noncase study used disproportionality analysis (case-noncase design) to detect signals of adverse reaction of interest reported with finasteride in VigiBase, the World Health Organization's global database of individual case safety reports. To explore the strength of association, the reporting odds ratio (ROR), a surrogate measure of association used in disproportionality analysis, was used. Extensive sensitivity analyses included stratifying by indication (BPH and alopecia) and age (≤45 and >45 years); comparing finasteride signals with those of drugs with different mechanisms but used for similar indications (minoxidil for alopecia and tamsulosin hydrochloride for BPH); comparing finasteride with a drug with a similar mechanism of action and adverse event profile (dutasteride); and comparing reports of suicidality before and after 2012. Data were obtained in June 2019 and analyzed from January 25 to February 28, 2020. Exposures:Reported finasteride use. Main Outcomes and Measures:Suicidality and psychological adverse events. Results:VigiBase contained 356 reports of suicidality and 2926 reports of psychological adverse events (total of 3282 adverse events of interest) in finasteride users (3206 male [98.9%]; 615 of 868 [70.9%] with data available aged 18-44 years). A significant disproportionality signal for suicidality (ROR, 1.63; 95% CI, 1.47-1.81) and psychological adverse events (ROR, 4.33; 95% CI, 4.17-4.49) in finasteride was identified. In sensitivity analyses, younger patients (ROR, 3.47; 95% CI, 2.90-4.15) and those with alopecia (ROR, 2.06; 95% CI, 1.81-2.34) had significant disproportionality signals for increased suicidality; such signals were not detected in older patients with BPH. Sensitivity analyses also showed that the reports of these adverse events significantly increased after 2012 (ROR, 2.13; 95% CI, 1.91-2.39). Conclusions and Relevance:In this pharmacovigilance case-noncase study, significant RORs of suicidality and psychological adverse events were associated with finasteride use in patients younger than 45 years who used finasteride for alopecia. The sensitivity analyses suggest that these disproportional signals of adverse events may be due to stimulated reporting and/or younger patients being more vulnerable to finasteride's adverse effects.
journal_name
JAMA Dermatoljournal_title
JAMA dermatologyauthors
Nguyen DD,Marchese M,Cone EB,Paciotti M,Basaria S,Bhojani N,Trinh QDdoi
10.1001/jamadermatol.2020.3385subject
Has Abstractpub_date
2021-01-01 00:00:00pages
35-42issue
1eissn
2168-6068issn
2168-6084pii
2772818journal_volume
157pub_type
杂志文章相关文献
JAMA Dermatology文献大全abstract:BACKGROUND:Immune reconstitution inflammatory syndrome (IRIS) is a phenomenon initially described in patients with human immunodeficiency virus. Upon initiation of combination antiretroviral therapy, recovery of cellular immunity triggers inflammation to a preexisting infection or antigen that causes paradoxical worsen...
journal_title:JAMA dermatology
pub_type: 杂志文章,评审
doi:10.1001/2013.jamadermatol.503
更新日期:2013-01-01 00:00:00
abstract:Importance:Patients with vascular malformations (VAMs) and vascular overgrowth syndromes have lower health-related quality of life (HRQoL) attributable to social stigmatization, poor mental health, severity, and pain. However, the factors that contribute to this decreased HRQoL are not clear. Objective:To perform a sy...
journal_title:JAMA dermatology
pub_type: 杂志文章,meta分析
doi:10.1001/jamadermatol.2018.0002
更新日期:2018-06-01 00:00:00
abstract:Importance:Melanoma treatment has been revolutionized with the development of immune-based therapies that offer durable clinical responses in a subset of patients. Clinical outcomes after treatment by immunotherapy can be influenced by the host's immune system. The immune system is modified with age by age-related immu...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.4584
更新日期:2018-01-01 00:00:00
abstract:Importance:Erythropoietic protoporphyria (EPP) is a rare hereditary disease of heme biosynthesis that manifests as severe photosensitivity and hepatotoxicity. There have been no effective treatments to date. Cimetidine has been shown to inhibit heme biosynthesis and results in symptomatic improvement in patients with a...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2016.2303
更新日期:2016-11-01 00:00:00
abstract:IMPORTANCE:Psoriasis and atopic dermatitis (AD) are inflammatory diseases thought to be mediated by helper T-cell subtypes 1 and 2 (TH1 and TH2), respectively. Although psoriasis and AD show histopathologic differences during chronic disease, they are difficult to distinguish histologically during erythrodermic exacerb...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2015.2
更新日期:2015-07-01 00:00:00
abstract:Importance:There are limited data among young adults on sunscreen use during childhood and adulthood and on the association of sunscreen use with melanoma risk. Objective:To assess correlates of early-life sunscreen use and the association between sunscreen use and risk of cutaneous melanoma before age 40 years. Desi...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2018.1774
更新日期:2018-09-01 00:00:00
abstract:Importance:The differential diagnosis between proliferative nodules (PNs) and melanoma arising in congenital melanocytic nevi (CMN) is crucial, as patients with PNs most often experience no increased risk of melanoma with metastases and death. Objective:To analyze the utility of immunohistochemistry and fluorescence i...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2016.2667
更新日期:2016-10-01 00:00:00
abstract:Importance:Necrobiotic xanthogranuloma (NXG) is a non-Langerhans cell histiocytosis classically associated with paraproteinemia attributable to plasma-cell dyscrasias or lymphoproliferative disorders. Despite the morbidity of NXG, the literature is limited to case reports and small studies, and diagnostic criteria are ...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2019.4221
更新日期:2020-03-01 00:00:00
abstract:Importance:Controversy persists regarding the appropriate management of incompletely excised, biopsy-proven, mild and moderate dysplastic nevi (DN). Objective:To determine long-term risk of associated melanoma in biopsied mild or moderate DN with positive histologic margins that were clinically observed vs reexcised w...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2016.2869
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:To calculate sunbed use prevalence rates, to investigate the motivations for tanning, and to identify typical target groups for interventions to prevent skin cancer. DESIGN:Cross-sectional, representative, population-based study, primary analysis of the SUN-Study 2012 (Sunbed-Use: Needs for Action-Study). ...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/2013.jamadermatol.562
更新日期:2013-01-01 00:00:00
abstract:Importance:Pubic hair grooming is a common practice that can lead to injury and morbidity. Objective:To identify demographic and behavioral risk factors associated with pubic hair grooming-related injuries to characterize individuals with high risk of injury and develop recommendations for safe grooming practices. De...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.2815
更新日期:2017-11-01 00:00:00
abstract:IMPORTANCE:Recent data demonstrated somatic mutations in GJB2 that were present in affected porokeratotic eccrine ostial and dermal duct nevus (PEODDN) tissue but absent in unaffected skin. Recognizing that PEODDN lesions can also appear in individuals with keratitis-ichthyosis-deafness syndrome and finding somatic mut...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2014.5069
更新日期:2015-06-01 00:00:00
abstract:IMPORTANCE:The differential diagnosis for oral lentigines includes several syndromes with important associated systemic findings. McCune-Albright syndrome (MAS), a mosaic condition associated with café au lait pigmentation, is not typically considered a mucosal lentiginosis syndrome. The clinical phenotype of MAS is va...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2014.184
更新日期:2014-07-01 00:00:00
abstract:Importance:Cutaneous squamous cell carcinoma (cSCC) has metastatic potential, but the prognostic value of current staging systems in nonselected patients is uncertain. Objective:To assess the effect of risk factors for metastasis and to evaluate validity and usefulness of 4 staging systems for cSCC using population-ba...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.6428
更新日期:2018-04-01 00:00:00
abstract:IMPORTANCE:Mutations driving melanoma growth have diagnostic, prognostic, and therapeutic implications. Traditional classification systems do not correlate optimally with underlying melanoma growth-promoting mutations. Our objective was to determine whether unique dermoscopic growth patterns directly correlate with dri...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2013.8442
更新日期:2014-06-01 00:00:00
abstract:Importance:Increased rates of autoimmune conditions have been reported in association with systemic lupus erythematosus (SLE). Little is known about coexisting autoimmune conditions in patients with cutaneous lupus erythematosus (CLE) without SLE. Objective:To determine the prevalence and risk factors of having coexis...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2018.0616
更新日期:2018-06-01 00:00:00
abstract:Importance:Granuloma faciale (GF) is a rare, benign inflammatory dermatosis of unknown cause. Some reports have suggested that it could be part of the spectrum of IgG4-related sclerosing diseases. Granuloma faciale is characterized by single or multiple red-brown nodules, most frequently occurring on the face, and it c...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2018.2681
更新日期:2018-11-01 00:00:00
abstract:Importance:Systemic and inhaled corticosteroids negatively affect bone remodeling and cause osteoporosis and bone fracture when given continuously or in high doses. However, risk of osteoporosis and major osteoporotic fracture (MOF) after application of topical corticosteroids (TCSs) is largely unexplored. Objective:T...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2020.4968
更新日期:2021-01-20 00:00:00
abstract:Importance:Use of systemic therapies for moderate to severe psoriasis in children is increasing, but comparative data on their use and toxicities are limited. Objective:To assess patterns of use and relative risks of systemic agents for moderate to severe psoriasis in children. Design, Setting, and Participants:A ret...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.3029
更新日期:2017-11-01 00:00:00
abstract:IMPORTANCE:Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT), occurs in elderly patients and has been considered as a lymphoma with a poor prognosis, with estimated 5-year specific survival rates of approximately 50%. The hypothesis of an improvement in prognosis over time has not been studied. OB...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2013.7452
更新日期:2014-05-01 00:00:00
abstract:Importance:There is limited information regarding the influence of patient demographics, tumor characteristics, and treatment type on the survival of patients with dermatofibrosarcoma protuberans (DFSP). Objective:To assess prognostic factors and to evaluate the influence of treatment modality on overall survival of p...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2016.1886
更新日期:2016-12-01 00:00:00
abstract:IMPORTANCE:Sarcoidosis is a chronic granulomatous disease for which there are limited therapeutic options. This is the first randomized, placebo-controlled study to demonstrate that antimycobacterial therapy reduces lesion diameter and disease severity among patients with chronic cutaneous sarcoidosis. OBJECTIVE:To ev...
journal_title:JAMA dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamadermatol.2013.4646
更新日期:2013-09-01 00:00:00
abstract:IMPORTANCE:The efficacy of treatment for psoriasis must be balanced against potential adverse events. OBJECTIVE:To determine the effect of treatment on the risk of serious infections in patients with psoriasis. DESIGN, SETTING, AND PARTICIPANTS:A multicenter, longitudinal, disease-based registry (Psoriasis Longitudin...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamadermatol.2015.0718
更新日期:2015-09-01 00:00:00
abstract:IMPORTANCE:Hidradenitis suppurativa (HS) is a chronic cutaneous disease with acutely painful flares that require appropriate and timely treatment. OBJECTIVE:To assess how individuals with HS utilize medical care, especially emergency department (ED) care, a high-cost setting, and to describe the health care costs for ...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2014.691
更新日期:2014-09-01 00:00:00
abstract:Importance:Although regression is commonly observed in cutaneous melanoma, it is uncertain whether it is associated with patient prognosis. Objective:To determine whether histologically confirmed regression was associated with better or worse survival in patients with primary cutaneous melanoma. Design, Setting, and ...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2020.5032
更新日期:2020-12-23 00:00:00
abstract:Importance:How patients' mental health is associated with their satisfaction with physicians is rarely studied among adults with skin conditions. Objective:To examine the association between mental health comorbidities in patients with psoriasis and their satisfaction with physicians. Design, Setting, and Participant...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2020.1054
更新日期:2020-07-01 00:00:00
abstract:IMPORTANCE:Pseudoaneurysm is a well-known complication of trauma and iatrogenic injury to the vasculature. We report 3 cases of postsurgical pseudoaneurysm after Mohs surgery. OBSERVATIONS:Three patients who underwent Mohs surgery for nonmelanoma skin cancers presented between 2 and 4 weeks after surgery with several ...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2013.9073
更新日期:2014-05-01 00:00:00
abstract:Importance:Dermatologists, pulmonologists, and rheumatologists study and treat patients with sarcoidosis with cutaneous manifestations. The validity of cutaneous sarcoidosis outcome instruments for use across medical specialties remains unknown. Objective:To assess the reliability and validity of cutaneous sarcoidosis...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2015.2008
更新日期:2015-12-01 00:00:00
abstract:IMPORTANCE:Basal cell carcinomas (BCCs) are diagnosed by clinical evaluation, which can include dermoscopic evaluation, biopsy, and histopathologic examination. Recent translation of multiphoton microscopy (MPM) to clinical practice raises the possibility of noninvasive, label-free in vivo imaging of BCCs that could re...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2015.0453
更新日期:2015-10-01 00:00:00
abstract:Importance:The dupilumab regimen of 300 mg every 2 weeks is approved for uncontrolled, moderate to severe atopic dermatitis (AD). Objective:To assess the efficacy and safety of different dupilumab regimens in maintaining response after 16 weeks of initial treatment. Design, Setting, and Participants:The Study to Conf...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamadermatol.2019.3617
更新日期:2020-02-01 00:00:00