Sex-Related Differences in Drugs with Anti-Inflammatory Properties

Journal of Clinical Medicine

Christoph Baumgärtel¹  Martin Czejka²  André Farkouh²  Alexandra Kautzky-Willer³  Margit Hemetsberger⁴  Roman Gottardi⁵ 

[1] AGES Austrian Medicines and Medical Devices Agency and Austrian Federal Office for Safety in Health Care, 1200 Vienna, Austria;Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria;Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria;Hemetsberger Medical Services, 1070 Vienna, Austria;Vascular Surgery, MediClin Heart Institute Lahr/Baden, 77933 Lahr, Germany;

关键词: sex;    gender;    NSAID;    anti-inflammatory drug;    pharmacokinetics;    pharmacodynamics;   

DOI  :  10.3390/jcm10071441

来源: DOAJ

【 摘 要 】

There is increasing evidence of sex differences in the action of anti-inflammatory drugs, with women being at significantly higher risk of adverse effects. Nevertheless, clinicians’ awareness of the implications of these sex differences on dosing and adverse event monitoring in routine practice is still in need of improvement. We reviewed the literature evaluating sex differences in terms of pharmacokinetics and pharmacodynamics of anti-inflammatory drugs. The anti-thrombotic activity of selective and non-selective COX-inhibitors tends to be stronger in men than women. Side effect profiles differ with regards to gastro-intestinal, renal and hepatic complications. Glucocorticosteroids were found to be more effective in men; women were more sensitive to corticosteroids when their oestradiol levels were high, a finding important for women taking hormonal contraception. TNF-alpha inhibitors have a longer half-life in men, leading to stronger immunosuppression and this a higher incidence of infections as side effects. Although research on sex differences in the effectiveness and safety of drugs is increasing, findings are often anecdotal and controversial. There is no systematic sex-differentiated reporting from clinical trials, and women are often under-represented. As personalized medicine is gaining in importance, sex, and gender aspects need to become integral parts of future research and policy making.

【 授权许可】

Unknown