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From: Bryan
Date: 3/4/2002
Time: 7:11:31 PM
Remote Name: 209.223.26.214
>>I trust your judgement, but seeing as it is by far one of the more potent antiandrogens out there (blowing spiro out of the water) i just want to get the scoop on it. here's the link. I want your opinion.<<
>>http://www.ama-assn.org/special/womh/library/readroom/arch98/dst7044.htm<<
A couple of separate issues I'd like to comment on:
1) I'd be curious to know exactly what context you're using when you say that cyproterone acetate "blows spiro out of the water". If you're talking about the ORAL, systemic use of those drugs, then I'd have to agree: it seems likely that the rapid metabolization of oral spironolactone into less powerful substances makes it inferior to cyproterone acetate, even though spiro has a much higher binding affinity to the androgen receptor (67% compared to 12.5%, according to one study) than CA.
However, things are different when you start talking about *topical* spiro and *topical* CA. Looking at the available studies that used both drugs topically, it appears that spiro is at least as good as CA. Check out the hamster flank organ study in the Online Library at www.hairlosstalk.com: they compared spiro and CA head-to-head, and the two were almost IDENTICAL in performance: 0.3 mg of spiro produced a flank-organ inhibition of 39.3%, and 0.3 mg of CA produced an inhibition of 39.7% (on the treated side, but unfortunately there was also a 30.3% inhibition on the NON-treated side, showing systemic absorption). In earlier human studies, it seems like we'd have to give a slight edge to topical spiro over topical CA: an early study by Cunliffe (cited at your link above) found no results from topical CA in a standard vehicle, while early studies with topical spiro have at least yielded somewhat mixed results.
2) Having said all that, I was very pleased to read the study that you linked above!! The critical difference in that one is that they used an unusual topical vehicle; namely, liposomes!! Apparently, that really made a difference, and gives me hope that there really is something to that technology! In fact, it makes me consider more seriously topical SPIRO in a liposome vehicle, like the product that www.lipoxidil.com sells! I sincerely hope that someone comes out with a study that tests liposomal spiro!
Bryan
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