New research suggests that the hair loss drug spironolactone may be safe to treat female pattern hair loss in breast cancer survivors and is not associated with an increased risk of breast cancer recurrence.

Androgens play a significant role in the pathogenesis of female pattern hair loss. The current treatment of topically applied minoxidil is believed to increase scalp blood flow and maintain hair growth, according to the study. Antiandrogen drugs, such as spironolactone, can also be used to treat female pattern hair loss but are currently used off-label.

“Spironolactone is used for androgenic alopecia because of its ability to halt the progression of hair loss and its long-term safety profile,” said senior author Adam Friedman, MD, in a press release. “However, little is known about its safety in breast cancer survivors, which is of concern considering the drug’s estrogenic effects could pose a theoretical risk of breast cancer recurrence.”

To investigate, researchers conducted a retrospective analysis using data from the Humana Insurance Database. They identified patients with a history of breast cancer and stratified groups based on spironolactone usage, then analyzed patient characteristics and cancer recurrence rates between the cohorts.

According to a press release, the breast cancer recurrence rate for the group prescribed spironolactone was not statistically different from the cohort of patients who did not take the drug, after adjusting for patient characteristics. The recurrence rate for both groups was well within the expected range.

“According to our analysis, spironolactone is not independently responsible for increased risk of breast cancer recurrence,” Friedman said. “The drug could be used as an additional treatment option for alopecia in female breast cancer patients who are disease-free.”

The authors said future studies and clinical trials should assess the efficacy and safety of spironolactone in patients who have cancer remission in order to confirm its safety.

REFERENCE
Hair Loss Drug Spironolactone May Be Safe for Use in Breast Cancer Survivors [news release]. George Washington School of Medicine and Health Sciences; September 9, 2020. https://smhs.gwu.edu/news/hair-loss-drug-spironolactone-may-be-safe-use-breast-cancer-survivors. Accessed September 15, 2020.