Ce comparateur présente l'état de la littérature scientifique. Ce n'est pas un avis médical : seul un médecin peut dire ce qui convient à votre situation.
Chez la femme atteinte d'alopécie androgénétique, l'association minoxidil topique 2 % et spironolactone orale 100 mg n'a été évaluée que dans deux études de fiabilité limitée. En 17 semaines, elle fait significativement mieux que l'association minoxidil et finastéride oral 5 mg : 70 % des patientes (21 sur 30) sont améliorées sur photos jugées à l'aveugle, contre 33,3 % (Sadeghzadeh Bazargan 2024). En 24 semaines, le stade de l'alopécie féminine baisse de 4,1 à 3,3, un peu moins qu'avec du bicalutamide oral 50 mg à la place de la spironolactone (de 3,9 à 2,8), sans que l'écart soit testé (Jha 2024). Les arrêts pour effet indésirable restent mal cernés (preuves très faibles) : 2 femmes sur 30 dans une étude, 8 sur 60 dans l'autre.
Votre profil
Tolérance
Ce que disent les études, une question à la fois. Les plus solides d'abord.
Arrête-t-on souvent l'association minoxidil 2 % et spironolactone à cause d'un effet indésirable ?
Preuves très faiblesRésultats concordants2 essais, 180 participants, suivi jusqu'à 24 semainesFemmes · Alopécie androgénétique
Sous minoxidil 2 % associé à la spironolactone 100 mg, 2 femmes sur 30 arrêtent pour un effet indésirable en 17 semaines (Sadeghzadeh Bazargan 2024), et 8 sur 60 en 24 semaines, contre 2 sur 60 quand le minoxidil est associé au bicalutamide 50 mg (Jha 2024).
Pourquoi ce niveau de preuve
Point de départ élevé pour l'essai, bas pour la cohorte, tous deux à risque de biais élevé. Dégradé jusqu'à très faible : risque de biais et quelques cas seulement, sans placebo.
Niveau abaissé pour : risque de biais, imprécision.
Indice fragile, à confirmer par d'autres essais.
À qui ça s’applique
Femmes de 18 à 50 ans atteintes d'alopécie androgénétique. Suivi de quatre à six mois.
Les chiffres et leurs sources (3)
Arrêt pour effet indésirable
2 sur 30 Minoxidil topique 2 % + spironolactone orale 100 mg face à Minoxidil topique 2 % + finastéride oral 5 mg
17 semaines · Sadeghzadeh 2024
Voir la citation
As for treatment complications, no serious adverse effects occurred
in patients in either group. Two cases from the spironolactone group
discontinued the drug due to menstrual irregularities and were ex-
cluded from the study.
Citation complémentaire (methode)
treatment was 4 months, and follow- up examinations were per-
formed 2 and 4 months after the start of treatment. The efficacy of
the treatment was evaluated by the following criteria: determina-
tion of the degree of hair loss using the Ludwig grade for FPHL and
the Norwood– Hamilton grade for MPHL, determination of physician
satisfaction by clinical images using the physician global assessment
score (no change, little, somewhat, good, and excellent), and deter-
mination of patient satisfaction by clinical images according to the
density and thickness of the hair shafts and the extent of hair loss
(worsening, no change, and improvement).
Sadeghzadeh Bazargan A, Tavana Z, Dehghani A et al.. The efficacy of the combination of topical minoxidil and oral spironolactone compared with the combination of topical minoxidil and oral finasteride in women with androgenic alopecia, female and male hair loss patterns: a blinded randomized clinical trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15979. Citation sous licence CC-BY.
Arrêt pour effet indésirable
8 sur 60 Minoxidil topique 2 % + spironolactone orale 100 mg face à Minoxidil topique 2 % + bicalutamide oral 50 mg
24 semaines · Jha 2024
Voir la citation
follow- up for 24 weeks. Eight patients from Group A and
two patients from Group B did not complete 24 week fol-
low- up due to adverse effects. The differences in the base-
Jha AK, Zeeshan MD, Singh A et al.. Efficacy and safety of spironolactone versus bicalutamide in female pattern hair loss: a retrospective comparative study. Australasian Journal of Dermatology 2024, DOI 10.1111/ajd.14306. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Arrêt pour effet indésirable
2 sur 60 Minoxidil topique 2 % + bicalutamide oral 50 mg face à Minoxidil topique 2 % + spironolactone orale 100 mg
24 semaines · Jha 2024
Voir la citation
follow- up for 24 weeks. Eight patients from Group A and
two patients from Group B did not complete 24 week fol-
low- up due to adverse effects. The differences in the base-
Jha AK, Zeeshan MD, Singh A et al.. Efficacy and safety of spironolactone versus bicalutamide in female pattern hair loss: a retrospective comparative study. Australasian Journal of Dermatology 2024, DOI 10.1111/ajd.14306. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Autres résultats
Critères mesurés dans une seule étude : chaque ligne est un résultat isolé.
Efficacité
Amélioration marquée
8 sur 30face à Minoxidil topique 2 % + finastéride oral 5 mg
drugs used were ineffective in 2 (6.7%) cases in the minoxidil-
spironolactone group and in 5 (16.7%) cases in the minoxidil-
finasteride group. In addition, 13 (43.3%) and 16 (53%) cases in the
minoxidil- spironolactone and minoxidil- finasteride groups, respec-
tively, responded well to the treatment. The effect of treatment was
excellent in 8 (56.7%) and 0 (0%) of the mentioned groups, respec-
tively, and the mentioned difference was statistically significant (p:
0.01). The response to the treatment in the FPHL was not statisti-
Citation complémentaire (methode)
treatment was 4 months, and follow- up examinations were per-
formed 2 and 4 months after the start of treatment. The efficacy of
the treatment was evaluated by the following criteria: determina-
tion of the degree of hair loss using the Ludwig grade for FPHL and
the Norwood– Hamilton grade for MPHL, determination of physician
satisfaction by clinical images using the physician global assessment
score (no change, little, somewhat, good, and excellent), and deter-
mination of patient satisfaction by clinical images according to the
density and thickness of the hair shafts and the extent of hair loss
(worsening, no change, and improvement).
Sadeghzadeh Bazargan A, Tavana Z, Dehghani A et al.. The efficacy of the combination of topical minoxidil and oral spironolactone compared with the combination of topical minoxidil and oral finasteride in women with androgenic alopecia, female and male hair loss patterns: a blinded randomized clinical trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15979. Citation sous licence CC-BY.
nificant. Mean hair loss severity at baseline and 24 weeks was
Sinclair 4.1 and Sinclair 3.3 in spironolactone group whereas
Sinclair 3.9 and Sinclair 2.8 in bicalutamide group (Table 1).
Jha AK, Zeeshan MD, Singh A et al.. Efficacy and safety of spironolactone versus bicalutamide in female pattern hair loss: a retrospective comparative study. Australasian Journal of Dermatology 2024, DOI 10.1111/ajd.14306. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Patients améliorés (panel photo en aveugle)
70 % (21 sur 30)face à Minoxidil topique 2 % + finastéride oral 5 mg
(70.0%) and 10 (33.3%) cases, respectively, p: 0.01), Figures 1,2.
Citation complémentaire (methode)
treatment was 4 months, and follow- up examinations were per-
formed 2 and 4 months after the start of treatment. The efficacy of
the treatment was evaluated by the following criteria: determina-
tion of the degree of hair loss using the Ludwig grade for FPHL and
the Norwood– Hamilton grade for MPHL, determination of physician
satisfaction by clinical images using the physician global assessment
score (no change, little, somewhat, good, and excellent), and deter-
mination of patient satisfaction by clinical images according to the
density and thickness of the hair shafts and the extent of hair loss
(worsening, no change, and improvement).
Citation complémentaire (valeur)
spironolactone group than in the minoxidil- finasteride group (21
Sadeghzadeh Bazargan A, Tavana Z, Dehghani A et al.. The efficacy of the combination of topical minoxidil and oral spironolactone compared with the combination of topical minoxidil and oral finasteride in women with androgenic alopecia, female and male hair loss patterns: a blinded randomized clinical trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15979. Citation sous licence CC-BY.
Patients sans réponse au traitement
6,7 % (2 sur 30)face à Minoxidil topique 2 % + finastéride oral 5 mg
drugs used were ineffective in 2 (6.7%) cases in the minoxidil-
spironolactone group and in 5 (16.7%) cases in the minoxidil-
finasteride group. In addition, 13 (43.3%) and 16 (53%) cases in the
minoxidil- spironolactone and minoxidil- finasteride groups, respec-
tively, responded well to the treatment. The effect of treatment was
excellent in 8 (56.7%) and 0 (0%) of the mentioned groups, respec-
tively, and the mentioned difference was statistically significant (p:
0.01). The response to the treatment in the FPHL was not statisti-
Citation complémentaire (methode)
treatment was 4 months, and follow- up examinations were per-
formed 2 and 4 months after the start of treatment. The efficacy of
the treatment was evaluated by the following criteria: determina-
tion of the degree of hair loss using the Ludwig grade for FPHL and
the Norwood– Hamilton grade for MPHL, determination of physician
satisfaction by clinical images using the physician global assessment
score (no change, little, somewhat, good, and excellent), and deter-
mination of patient satisfaction by clinical images according to the
density and thickness of the hair shafts and the extent of hair loss
(worsening, no change, and improvement).
Sadeghzadeh Bazargan A, Tavana Z, Dehghani A et al.. The efficacy of the combination of topical minoxidil and oral spironolactone compared with the combination of topical minoxidil and oral finasteride in women with androgenic alopecia, female and male hair loss patterns: a blinded randomized clinical trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15979. Citation sous licence CC-BY.
1–6). The mean reduction in hair shedding score at base-
line and 24 weeks was 4.9 and 2.4 in the spironolactone for
rules
group and 4.6 and 1.8 in the bicalutamide group (Table 2)
Jha AK, Zeeshan MD, Singh A et al.. Efficacy and safety of spironolactone versus bicalutamide in female pattern hair loss: a retrospective comparative study. Australasian Journal of Dermatology 2024, DOI 10.1111/ajd.14306. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Comparé directement à
Traitements testés contre celui-ci dans un même essai, sur les mêmes patients.
Sadeghzadeh 2024 · Essai randomisé, risque de biais élevé. The efficacy of the combination of topical minoxidil and oral spironolactone compared with the combination of topical minoxidil and oral finasteride in women with androgenic alopecia, female and male hair loss patterns: a blinded randomized clinical trial
Jha 2024 · Étude de cohorte, risque de biais élevé. Efficacy and safety of spironolactone versus bicalutamide in female pattern hair loss: a retrospective comparative study