Thanks for linking that article @holyhead.
Of note, the article states:
Lastly, a few years ago there was an article published in JAMA Dermatology that critiqued every one of the clinical trials to date that were published on finasteride. The main critique was that they were simply not effectively designed to sensitize for low frequency, persistent side effects. This article seems prescient now because Merck didn’t report the patients who dropped out of their study and there were apparently PFS patients within this group. This does not seem to have been an accident in retrospect in light of the documents that are now available.
Which is a huge problem in clinical studies of pharmaceuticals in general:
Another main limitation of ADR detection and quantification using RCTs is their limited sample size. but their relatively short follow up time compared with the length of drug use in clinical practice, particularly in the cases of interventions that require chronic treatment such as epilepsy and schizophrenia, limits the ability of RCTs to detect ADRs. This presents an obstacle to detecting ADRs that appear at a time lag from the drug exposure, such as cancer, or those that develop after chronic use such as the long-term ADRs of oral contraceptives and hormone replacement therapy that can take years to develop. In addition, rare ADRs cannot be detected by RCTs because RCTs do not contain sufficiently large populations.
Also this caught my eye from the reddit poster.
Merck has acted unethically throughout this whole controversy. I can share with you a couple anecdotes with you.
Although I can’t specifically provide names, Merck has interfered with the research publishing process. Somebody from company reached out to at least one journal editor who published an unfavorable study on finasteride. Merck pressured them to withhold support to the journal if the editor did it again.
In a just society that anonymous person in the unverified anecdote would be held criminally accountable.
I applaud Dr. Rassman for writing that post. He’s got a lot of money to earn from hair procedures, including prescribing Finasteride.
Yet, he goes on record and calls out Merck for their crooked work. I encourage you all to read the article, but let me write the crux of it.
“Although I can’t specifically provide names, Merck has interfered with the research publishing process. Somebody from company reached out to at least one journal editor who published an unfavorable study on finasteride. Merck pressured them to withhold support to the journal if the editor did it again.
Personally, I had a physician reach out to Merck about a decade ago to figure out what was going on with my health. The physician spoke with a pharmacovigilance contact, but I don’t remember the name it was so long again. The person said Merck had never received any reports of sexual dysfunction. This was clearly false because of the data that was hidden from the clinical trials. Additionally, at that time Merck had already been forced to warn of such side effects in European countries. And this was shortly before the FDA forced a label change in 2012 to include post-marketing reports, all of which happened before my outreach to Merck.
These are all things I know factually to be true but I can’t provide “proof” until it gets into the public domain. I hope it gets there, but it may never be the case. But if you look at Merck’s response to Vioxx, they did many of the same things I just described for their response to the Propecia scandal.“
Yeah I think we know why studies take so long??? Wouldn’t be surprised if this guy “disappears”…
@Dubya_B moved the comments you made into its own topic because it deserves its own topic as it kind of strays from the original topic, but also is an important blog written.
He didn’t write this, he reposted it. He would not and could never write any of this himself, and if he did, it would be a huge lie.
Yes, it is a repost of a Redditor’s opinion. But I still give him kudos for the repost. On Reddit, he’s obnoxiously the poster boy for Finasteride. But lately I’ve seen a couple examples of him admitting to persistent side effects of Fin.
I’m not saying he’s genuinely changing his entire stance on Fin, but I think it’s a positive step for the addressing the reality of the situation.
Dr Rassman’s posts on Reddit was what convinced me to take Fin. He wrote how he prescribed the poison to his son and he got an INCREASED libido on it. So I thought, how bad could it be if he’s willing to give it to his own son? Jeez imagine if his son gets pfs
When I read reviews for saw palmetto, I also saw reviews for "increased libido " I guess the AR overexpression is good for some
If you search hyperandrogenicity, you’ll see some members post about actually having a higher libido and more hair loss. At a glance, their symptoms seem more physical and skin-related.
There is a concept in pharmacology called a paradoxical reaction. You can get the opposite reaction of what you expect depending on the person that receives the drug or the dose of the drug. Personalized medicine is not too far off in the future I think but the scientific method in its current form isn’t good at incorporating these complex issues. We’re at the cutting edge. In the past, doctors would put leeches on people to cure them of their ailments.