Bryan said:
Depends on exactly how you define "outperform". BTW, I'm not sure why you refer to haircounts and hairweights as "semantics". Haircounts and hairweights are HARD DATA, as in NUMBERS on a page!
maddoc23 said:
True, but the semantics for me comes into play when we deal with haircounts because one researcher from another may interpret haircounts to include different types of hairs (terminal, vellous, etc.)
Sure, but the very best ones and the ones I rely on the most are the ones that clearly discriminate between the various types of hair. I can show you some excellent topical minoxidil studies that clearly differentiated between vellus, intermediate, and terminal hairs. Furthermore, the point still remains that all these studies I'm talking about were from different researchers in different labs all around the lab. What do you think is the probablility that JUST BY CHANCE ALONE, all the ones investigating topical minoxidil just happened to use methods that favored increased haircounts, while the ones investigating finasteride used methods that produced decreased haircounts?? That would be astronomically unlikely! It's a really weak argument if all you can say is, well, it's just an accident in the way they counted hairs in those studies!
maddoc23 said:
Also, hairweights is tricky because while we all agree hairweights going up is good, but how does this translate to observable results if at all. Forget about this topic, as it isn't as important to this discussion.
LOL! I've had lots of other people who tried to take me on on this issue, say that it's not the HAIRCOUNTS that are important, but the HAIRWEIGHTS! Just for the sake of completeness, I include BOTH issues in this discussion!
maddoc23 said:
OTOH, I can compare the hard data (those haircounts and hairweights that you mentioned) from around 20 or so other minoxidil and finasteride studies, and minoxidil beats-out finasteride pretty consistently.
Again, I don't believe it is as simple as that. I think the most valid studies are the ones that directly compared the two drugs(like the one I cited), rather than studies that studied one drug and then cross-referenced with another group that studied the other drug.
True, but there have only been a couple studies that have done that, to the best of my knowledge, and they were both done in India (more on that later as a possibly important detail). Furthermore, finasteride has a certain built-in advantage over topical minoxidil, in that minoxidil has more of a direct effect where it's actually applied, as opposed to finasteride, which obviously affects the entire scalp. If you compare the two using so-called "global photographic assessment", then finasteride gets an extra built-in benefit. But minoxidil rather consistently outperforms finasteride PER UNIT AREA OF SCALP, which is what I've always tried to make clear.
maddoc23 said:
Compounded with that, Rogaine's own trial data (taken from their website) concluded rogaine regrew hair in ~55% of men, while propecia regrows in ~66%. Based on this simple truth, propecia would be the better regrowth agent.
LOL! I'm going to use the same argument here that you used against me earlier, which is that it's so difficult to specify the exact meaning of a statistic like that, it's ultimately useless for inter-study comparisons! I quit using alleged "data" like "response rates", etc., many years ago. I now stick with HARD data like haircounts and hairweights.
maddoc23 said:
A new document has been released stating hairweights and haircounts continually decline by 6% annually after the first year of use on 5% minoxidil (you should double check exact wordings, as I am paraphrasing). Time obviously is a big factor as well, minoxidil provides more growth quicker, but how about over time (2-3 years). Add up all these reasons and I don't believe rogaine "outperforms" propecia.
Of course not, not in that way!! Go back and look at the very first words I uttered in this thread, which were the following: "Depends on how you define 'outperform' ". I've only been saying FOR YEARS that topical minoxidil probably doesn't inhibit the fundamental balding process in any way, and nobody should use it for that purpose! But when I've said for the last five years or so that minoxidil "outperforms" finasteride, my CLEAR message has been that the average PEAK regrowth you get from minoxidil (after about one year or so) is greater than the average peak regrowth that you get with finasteride.
maddoc23 said:
Again, there are alot of different parameters and factors that should be considered. Rogaine in fact may outperform propecia under certain parameters, and if that is your position we should nail down those parameters, especially time of treatment.
I hope you now understand my position better than you did before.
maddoc23 said:
Propecia has been proven to regrow in more people than rogaine, and provide more regrowth after 1-2 years.
No, I wouldn't go THAT far. Summing it up in a nutshell, topical minoxidil clearly seems to be better in the short-term, and finasteride doubtlessly is better in the long-term. But exactly where that crossover point is between "short-term" and "long-term", is hard to say; furthermore, it seems to vary from one study to the next. You might want to take a look at Elise Olsen's long-term study of minoxidil which lasted for a full 5 years. After 5 years, the NONVELLUS haircounts were still 211 above the starting baseline! Finasteride has never gotten anywhere NEAR a figure like that, even after its 1-year peak! :wink:
maddoc23 said:
See another study. Journals@Ovid Full Text Saraswat, Abir MD, DNB; Kumar, Bhushan MD, MNAMS Minoxidil vs Finasteride in the Treatment of Men With Androgenetic Alopecia. [Letter] Archives of Dermatology. 139(9):1219-1221, September 2003. This study shows propecia regrew ~70% more hair than rogaine after 24 months, according to the chart!!!!
I made a mistake earlier when I said that the other study was the one that found that finasteride was only "marginally more effective" than topical minoxidil. It was the one you just cited above which found that! Furthermore, they only used the 2% version of Rogaine! And the 70% figure is ridiculous: they made a mistake in that graph, with some of the lines being mis-labeled. I even emailed the authors to let them know about that. NEVER EVER has finasteride grown 70% more hair than Rogaine! It was just a mistake.
I want to point out something else here that _may_ be important: the only two studies that have ever been done directly comparing finasteride and minoxidil were BOTH done in India. I suspect that Indian men have a natural genetic predisposition to do better with finasteride, because the results of those two studies are at odds with all the other ones that have been done. I can't PROVE that theory, but it seems like a reasonable explanation to me.
maddoc23 said:
I think you and I are on the same page in that EBM is the way to go...
What is "EBM"?
maddoc23 said:
...and I would like to read anything you have found that studied the two drugs side by side.
You need to take a look at the two recent studies done by Vera Price! They _almost_ meet that definition of "side by side", because even though they were two separate studies, Dr. Price used EXACTLY the same methods to evaluate both haircounts and hairweights with finasteride and topical minoxidil. And once again, minoxidil beat-out finasteride in both counts and weights.
maddoc23 said:
I think cross referencing studies just adds error into the equation, better to have more constants when evaluating data.
Yes, but once again, how on earth can you explain the CONSISTENT results in so many studies, done by so many different researchers, in so many different labs??
maddoc23 said:
I have provided 2 studies that have directly compared the two agents (and 2 more below),and found propecia to perform better. I would be very interested if you know of any studies that directly compared the two drugs with results to back up your position.
