Whatever happened to all those other DHT inhibitor drugs?

[Pondle]

What on Earth became of turosteride, episteride, MK-963, MK-434 and MK-386? MK-386 was the type I blocker that proved ineffective for male pattern baldness, wasn't it, but what about all the others? Were they relatively ineffective compared to finasteride/dutasteride, and/or not commercially viable?

 

[Bryan]

They obviously settled on the one agent that they thought was the best of the lot (finasteride), and went with it. No reason to spend hundreds of millions of bucks a pop on any of the others, just to get them approved.

 

[Pondle]

I thought finasteride was the first of the bunch, and some of the others were researched later, inhibited type I as well as type II, etc?

 

[Bryan]

I have an old article written by Merck scientists in which they list a whole bunch of various synthetic steroids they designed for the purpose of inhibiting 5a-reductase; I'm talking maybe a couple dozen or so. Finasteride was just one of many. Apparently, it was the one that worked the best, and had the most desirable properties for their intended uses. For example, it had little or no affinity for the androgen receptor, and had no known effect on any other enzymes, receptors, or hormones. So finasteride is what they decided to go with. It was the best of the lot.

 

[Pondle]

I saw a reference in an article to so-called "second generation steroidal 5­a reductase inhibitors such as turosteride, MK­963, MK­434, episteride, and MK­386" which suggests that at least some of these came after finasteride, which was presumably the 'first generation' inhibitor? The article cited Chen W, Zouboulis CC, Orfanos CA. The 5á reductase system and its inhibitors. Recent development and its perspective in treating androgen dependent skin disorders. Dermatol 1996;193:177­-84.

BTW Bryan, do you think that we will see any future 5AR inhibitors, or indeed other types of oral pills for male pattern baldness, or is dutasteride the ultimate DHT blocker? Have you also seen this newsletter - http://www.hairlosstalk.com/newsletter/article47.htm? At the end it makes reference to a Merck spokesman suggesting that metformin and thiazolidinediones might be used for male pattern baldness. These are diabetes therapies! I've seen various discussions on the forum referring to the role of insulin resistance in male pattern baldness, usually involving docj and dammitletmein. Could you please comment on the potential role of these latter drugs in male pattern baldness treatment?