I think the confirmation that both type1 and type 2 genes are not methylated in plasma/blood is positive. It’s like we still have a “good” copy of our DNA
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Why are you disappointed? I think it’s very well written, easy to interpret and will likely open up new avenues.
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I was scared to read the part about our brain.
Who the f… is going to treat our brain is the most complicated organ!!!
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There are users around who know way more about the science than I do, but the clear thing is what @Papasmurf says - this is more news about the condition and about opening new research. 2020 may yet be our most important year.
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There are a lot of very serious problems with this paper.
One of them, and not even the biggest one, is the uncritical citation of the methodologically flawed study of Haber et al., 2019 to legitimize the denial of the damages done by finsteride. This study is so flawed that no self-respecting scientist would ever cite it, at least not without a long disclaimer.
Why is the study flawed? Imagine finasteride instantly killed 99% of its users. If you did a survey similar to the one cited, you would conclude that finasteride is 100% safe. If anyone with knowledge of statistics cares to elaborate more on this, please do.
There was also no mention in the paper of the fraud perpetrated by Merck in the original clinical trials of Finasteride.
On the basis of all this, the authors conclude that “Overall, these results indicate no consensus with respect to the presence of sexual side effects during treatment with 5α-R inhibitors.”
Great job, Diviccaro et al!
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how do you know you are taking the ones that inhibit the methylation at the genes we got methylated?
no one knows which substance or if more complex, which combination of substances would produce results for us, yet anyways
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Very nice study. I wonder if Baylor will show more than this
They better do with all the hype 
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PFS
“an alternative possibility is a direct action of finasteride on gut microbiota.”
In the future, more knowledge of this will probably lead to more sophisticated drug treatment across all fields of medicine.
The Haber study doesn’t look at people who discontinue finasteride. It also doesn’t look into how long people have been taking finasteride, which Kiguradze et al (2017) found was the primary predictor.
Finally, can we rely on written self-reports of sexual dysfunction? Have there been any general studies on the validity? Moore (2015) points out that SSRI sexual side effects were underreported because trials relied on spontaneous self-reports. The Haber study uses questionnaires to score on the ASEX scale.
I just found this interesting article:
Gordijn et al, March 2019
Adverse drug reactions on sexual functioning: a systematic overview
https://www.sciencedirect.com/science/article/pii/S1359644618304239?via%3Dihub
They write:
However, the awareness of sexual ADRs [adverse drug reactions] is still low under healthcare professionals and underreported during clinical trials.
P.S. References are here:
http://bit.ly/finasteride-research
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I think you are getting at the concept of a survivorship bias. The study looks at a pool of patients who have been taking the drug for a period of time and had the opportunity to drop out if they wanted to but didn’t. The people who had adverse events from finasteride would have stopped taking it, so you are weeding out those guys and the ones who remain don’t have them. You simply can’t determine the frequency of side effects for a drug from that kind of study because it’s hugely biased. I don’t know how that paper was peer-reviewed, but it was published somehow. To be honest though, I don’t know how you deal with that in a literature review that is going to be peer reviewed since it’s hard to say here is the literature but this one paper is total garbage. A lot of the anti-PFS authors have done stuff like that though.
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P.S. I found two studies that found the ASEX score valid and acceptable for research on sexual dysfunction.
A responsible literature review should evaluate the methodology of the papers it reviews. Meta-analyses typically set criteria for quality and methodology of the research under review, and eliminate studies that don’t meet the criteria.
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I took a look at this article again today to revisit the full context. I do wish the authors took a stronger stance in support of the existence of PFS but it isn’t all that bad. There was a paragraph where Melcangi explains how PFS cannot be adequately studied in larger cohorts, as it is a rare condition. That would apply to the Haber study and the others he mentioned.
I definitely do agree that the Haber study was terribly intellectually dishonest or moronic and should never have been published but the authors chose to be more diplomatic.
In terms of including the admission of fraud, I do hope that gets into the medical literature at some point. I don’t know if this article was submitted for review before the evidence of fraud became public.
We have Belknap’s controlled epidemiological study showing PFS exists, we have strong arguments that the other controlled studies are too low powered or inadequately designed to detect PFS, we have a Merck exec admitting they withheld information from the product label, and we’ve identified a couple biomarkers that are different in PFS versus healthy controls. What we lack is a very clear mechanism that is showing how taking finasteride causes PFS and why it happens in some people but not others. That’s a very ambitious goal to accomplish. People with vested interests will still fight this but we have more than enough evidence to show a more disinterested party that PFS is real. The biological mechanism may be the missing piece needed to convince some of the more stubborn-minded people that PFS is real.
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Hope Baylor will get published too
Sounds to me like they are about to the end of the line with it…
What do you base that statement on? Just curious as they something like 5 years overdue and I’m skeptical at this point they will ever release anything.
7 years overdue my friend , they sure must care about those 2 men that commit suicide after they did the study.
So has the study been completed but never released?
A year ago they said it was going through a peer review process, so apparently it’s done but I think Merck got involved, back in 2013 they said they had significant findings so there’s definitely something that is going on behind the scenes. Sorry if I sound like a conspiracy theorist but nothing about that study sounds right, Melcangi has been putting out studies on this without delay, Baylor still hasn’t done jack.